Sec. 17b-359. (Formerly Sec. 17-134x). Nursing facility: Preadmission screening process in the case of mentally ill persons. Annual resident review. Appeal.
Sec. 17b-359. (Formerly Sec. 17-134x). Nursing facility: Preadmission screening process in the case of mentally ill persons. Annual resident review. Appeal. (a)
For purposes of this section, the terms "mentally ill" and "specialized services" shall
be as defined in Subsections (e)(7)(G)(i) and (iii) of Section 1919 of the Social Security
Act and federal regulations.
(b) No nursing facility shall admit any person, irrespective of source of payment,
who has not undergone a preadmission screening process by which the Department of
Mental Health and Addiction Services determines, based upon an independent physical
and mental evaluation performed by or under the auspices of the Department of Social
Services, whether the person is mentally ill and, if so, whether such person requires the
level of services provided by a nursing facility and, if such person is mentally ill and
does require such level of services, whether the person requires specialized services. A
person who is determined to be mentally ill and not to require nursing facility level
services shall not be admitted to a nursing facility. In order to implement the preadmission review requirements of this section and to identify applicants for admission who
may be mentally ill and subject to the requirements of this section, nursing facilities
may not admit any person, irrespective of source of payment, unless an identification
screen developed, or in the case of out-of-state residents approved, by the Department
of Social Services has been completed and filed in accordance with federal law.
(c) No payment from any source shall be due to any nursing facility that admits a
resident in violation of the preadmission screening requirements of this section.
(d) A nursing facility shall notify the Department of Mental Health and Addiction
Services when a resident who is mentally ill undergoes a significant change in condition
or when a resident who has not previously been diagnosed as mentally ill undergoes a
change in condition which may require specialized services. Upon such notifications,
the Department of Mental Health and Addiction Services, under the auspices of the
Department of Social Services, shall perform an evaluation to determine whether the
resident requires the level of services provided by a nursing facility or requires specialized services for mental illness.
(e) The Department of Mental Health and Addiction Services, in consultation with
the Department of Social Services, may no less than annually review, within available
appropriations, the status of each resident in a nursing facility who is mentally ill to
determine whether the resident requires (1) the level of services provided by a nursing
facility, or (2) specialized services for mental illness. Nursing facilities shall grant to
the Department of Mental Health and Addiction Services and the Department of Social
Services access to nursing facility residents and their medical records for the purposes
of this section.
(f) In the case of a mentally ill resident who is determined under subsection (b), (d)
or (e) of this section not to require the level of services provided by a nursing facility
but to require specialized services for mental illness and who has continuously resided
in a nursing facility for at least thirty months before the date of the determination, the
resident may elect to remain in the facility or to receive services covered by Medicaid
in an alternative appropriate institutional or noninstitutional setting in accordance with
the alternative disposition plan submitted by the Department of Social Services to the
Secretary of the United States Department of Health and Human Services, and consistent
with the Department of Mental Health and Addiction Services requirements for the
provision of specialized services.
(g) In the case of a mentally ill resident who is determined under subsection (b),
(d) or (e) of this section not to require the level of services provided by a nursing facility
but to require specialized services for mental illness and who has not continuously
resided in a nursing facility for at least thirty months before the date of the determination,
the nursing facility in consultation with the Department of Mental Health and Addiction
Services shall arrange for the safe and orderly discharge of the resident from the facility.
If the department determines that the provision of specialized services requires an alternate residential placement, the discharge and transfer of the resident shall be made in
accordance with the alternative disposition plan submitted by the Department of Social
Services and approved by the Secretary of the United States Department of Health and
Human Services, except if an alternate residential placement is not available, the resident
shall not be transferred.
(h) In the case of a resident who is determined under subsection (b), (d) or (e) of
this section not to require the level of services provided by a nursing facility and not to
require specialized services, the nursing facility shall arrange for the safe and orderly
discharge of the resident from the facility.
(i) Any person seeking admittance to a nursing facility or any resident of a nursing
facility who is adversely affected by a determination of the Department of Mental Health
and Addiction Services under this section may appeal such determination to the Department of Social Services within fifteen days of the receipt of the notice of a determination
by the Department of Mental Health and Addiction Services. If an appeal is taken to
the Department of Social Services the determination of the Department of Mental Health
and Addiction Services shall be stayed pending determination by the Department of
Social Services.
(P.A. 89-348, S. 8, 10; P.A. 93-262, S. 1, 87; P.A. 95-257, S. 11, 58; June 18 Sp. Sess. P.A. 97-2, S. 135, 165; P.A. 07-217, S. 74; June Sp. Sess. P.A. 07-2, S. 63.)
History: P.A. 93-262 authorized substitution of commissioner and department of social services for commissioner and
department of income maintenance, effective July 1, 1993; Sec. 17-134x transferred to Sec. 17b-359 in 1995; P.A. 95-257
replaced Commissioner and Department of Mental Health with Commissioner and Department of Mental Health and
Addiction Services, effective July 1, 1995; June 18 Sp. Sess. P.A. 97-2 replaced "active treatment" with "specialized
services" and amended Subsec. (d) by eliminating an annual requirement that each resident of a nursing facility who is
mentally ill be reviewed by the Department of Mental Health and Addiction Services and replacing it with a requirement
that a nursing facility shall notify the Department of Mental Health and Addiction Services when a resident who is mentally
ill undergoes a significant change in condition or when a resident not previously diagnosed as mentally ill undergoes a
change in condition which may require specialized services, effective July 1, 1997; P.A. 07-217 made technical changes
in Subsecs. (e) to (g), effective July 12, 2007; June Sp. Sess. P.A. 07-2 added new Subsec. (e) authorizing Department of
Mental Health and Addiction Services, in consultation with Department of Social Services, to annually review each resident
of a nursing facility who is mentally ill to determine the appropriate level of services for such resident, redesignated existing
Subsecs. (e), (f), (g) and (h) as Subsecs. (f), (g), (h) and (i), respectively, and added references to Subsecs. (b) and (e) and
made technical changes in redesignated Subsecs. (f), (g) and (h), effective July 1, 2007.