Sec. 17b-360. (Formerly Sec. 17-134y). Nursing facility: Preadmission screening process in the case of persons with mental retardation or condition related thereto. Appeal.
Sec. 17b-360. (Formerly Sec. 17-134y). Nursing facility: Preadmission screening process in the case of persons with mental retardation or condition related
thereto. Appeal. (a) For purposes of this section, the terms "mental retardation", "a
condition related to mental retardation" and "specialized services" shall be as defined
in Subsection (e)(7)(G)(ii) of Section 1919 of the Social Security Act and federal regulations.
(b) No nursing facility may admit any new resident irrespective of source of payment, who has mental retardation or has a condition related to mental retardation unless
the Department of Developmental Services has determined prior to admission based
upon an independent physical and mental evaluation performed by or under the auspices
of the Department of Social Services that because of the physical and mental condition
of the individual, the individual requires the level of services provided by a nursing
facility. If the individual requires such level of services, the Department of Developmental Services shall also determine whether the individual requires specialized services
for such condition. An individual who is determined by the Department of Developmental Services to have mental retardation or to have a related condition and is determined not to require nursing facility level of 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 have mental retardation or have conditions
related to mental retardation and subject to the requirements of this section, nursing
facilities may not admit any individual 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 for the applicant and filed in
accordance with federal law.
(c) No payment from any source shall be due to a 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 Developmental Services when
a resident who has mental retardation undergoes a change in condition or when a resident
who has not previously been diagnosed as having mental retardation undergoes a significant change in condition which may require specialized services. Upon such notification,
the Department of Developmental 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 retardation.
(e) In the case of a resident who is determined under subsection (d) of this section
not to require the level of services provided by a nursing facility but to require specialized
services for mental retardation or a condition related to mental retardation and who has
continually 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 terms of 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.
(f) In the case of a resident with mental retardation or a related condition who is
determined under subsection (d) of this section not to require the level of services provided by a nursing facility but to require specialized services for mental retardation or
a related condition 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 Developmental 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 alternative residential placement, the discharge and
transfer of the patient shall be 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 alternative residential
facility is not available, the resident shall not be transferred.
(g) In the case of a resident who is determined under subsection (d) 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.
(h) The Department of Developmental Services shall be the agency responsible for
making the determinations required by this section on behalf of individuals who have
mental retardation and on behalf of individuals with conditions related to mental retardation and may provide services to such individuals to the extent required by federal law.
(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 Developmental 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 Developmental Services. If an appeal is taken to the Department of
Social Services, the determination of the Department of Developmental Services shall
be stayed pending determination by the Department of Social Services.
(P.A. 89-348, S. 9, 10; P.A. 93-262, S. 1, 87; June 18 Sp. Sess. P.A. 97-2, S. 136, 165; P.A. 05-288, S. 72; P.A. 06-196, S. 239; P.A. 07-73, S. 2(a).)
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. 17-134y transferred to Sec. 17b-360 in 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 the level of services each resident of a nursing home receives be evaluated and replacing it with a requirement that a nursing facility shall notify the Department of Mental Health and Addiction Services when a resident who has
mental retardation undergoes a change in condition or a resident who has not previously been diagnosed as having mental
retardation undergoes a significant change in condition which may require specialized services, effective July 1, 1997;
P.A. 05-288 made a technical change in Subsecs. (e), (f) and (g), effective July 13, 2005; P.A. 06-196 made technical
changes in Subsec. (f), effective June 7, 2006; pursuant to P.A. 07-73 "Department of Mental Retardation" was changed
editorially by the Revisors to "Department of Developmental Services", effective October 1, 2007.