epasrr training - hawaii: home · epasrr training for hospitals, nursing facilities, and community...

ePASRR Training for

Hospitals, Nursing Facilities, and Community Agencies

Tom Miller, MAExecutive Director, State & Corporate Services

Elizabeth Marsh, RN, BSN, MPHAssociate Director, State & Corporate Services

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Agenda• Overview of PASRR1 Process• Navigating the ePASRR application

— Account registration, logging in, searching for a patient, and PASRR Packet Creation

• Nursing facility assignment• Submitting monthly DHS 11372 census reports• Integrating PASRR compliance reviews• Accessing technical support

2 1. Preadmission Screening and Resident Review2. Department of Human Services 1137

Overview of the PASRR Process

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Transforming the PASRR Process

• Transitioning from a paper-based process to an electronic medium allows increase data integrity and security, efficiency, and improved quality.

• Advantages of the ePASRR system– Increases efficiency for accessing patient information– Reduces reliance on paper records– Improves coordination of care for patients– Promotes legible, complete, and accurate

documentation– Maximizes data security and availability of information

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Transforming the PASRR Process (cont.)

• Streamlined processing– No hard copy signatures– Consent to evaluations no longer required

• Key components of ePASRR– Level I & Level II PASRR packet submission– AMHD1/DD2 Level II determinations– Patient placement in nursing facility– Nursing facility bed status– Nursing facility DHS 1137 census submission– PASRR quarterly compliance reviews– Reports

51. Adult Mental Health Division2. Developmental Disabilities

Key Components

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• Level I & Level II PASRR packet submission• AMHD/DD Level II determinations• Patient placement in nursing facility• Nursing facility bed status• Nursing facility DHS 1137 census submission• PASRR quarterly compliance reviews• Reports

Overview of the PASRR Process

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User Roles in ePASRR

• Role-based access determined by user responsibilities– Hospital– Nursing Facility– AMHD– DDD1

– MQD2

– HSAG Admin

8 1. Developmental Disabilities Division2. MedQUEST Division (State of Hawaii Medicaid Agency)

Registering for an ePASRR Account

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Account Registration

• Enter https://epasrr.hsag.com in the address bar of the Web browser

• Click on the Register Here link within the Secure Login window

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https://epasrr.uat.hsag.com/

Account Registration (cont.)

• User Registration– Name, Email, and

Phone Number– Provider Type– Facility

• Click on the Registerbutton when all fields are completed

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• All registrations are reviewed/approved by HSAG

• Registration process– Registration—Request Received email sent to user– Registration—Request Approved email with link to

ePASRR registration page– Create an account password– Redirected to login page

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• Registration approval email

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• Click on Click Here link to be redirected to the Account Registration page


• Enter account password and click on the Register button– Password requirements

• Minimum of 8 characters, • At least 1 upper case and 1 lower case letter• At least 1 number• At least 1 special character

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Accessing the ePASRR Application

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Accessing ePASRR

• Steps to access the ePASRR application1. Open Web browser and enter

https://epasrr.hsag.com in the address bar2. Enter your User Name and Password; click on the

Login button

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https://epasrr.hsag.com

Accessing ePASRR (cont.)

• Secure Login screen

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• Steps to access the ePASRR application3. Two Factor Authentication

• Federal regulations require secondary authentication to confirm user access

• Click on the Submit button to generate email with random authentication code

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• Sample email

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• Once authentication code sent, the Verify Code screen will display

• Enter authentication code and click on the Submitbutton

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• Steps to access the ePASRR application4. Review and acknowledgement of ePASRR User

Agreement• One-time acknowledgement only• Describes use and disclosure requirements of ePASRR

data• Outlines responsibilities of ePASRR users• Users must agree to listed terms and conditions to

access the application

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• ePASRR User Agreement

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The ePASRR Application

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Accessing ePASRR—Home Page

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ePASRR Application—Home Page

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• User login/logout • Bed availability• PASRR Packet Queue

– Main queue for active cases• Select Status Filter; default status is Pending Level II

Determination and limited to DDD reviews• Users can sort and filter on any field in the grid

– Clicking on the section header will sort list in ascending or descending order

– Clicking on in the section header will allow filtering of search results


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• PASRR Packet Queue


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• Right navigation bar– Role-based list of potential actions

• Search for Patients• Reports • Resources & instructions

– Persistent across entire application

ePASRR Application—Search for Patients

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• How to find a patient– Select Search for Patients from

right navigation bar– From Patient Search screen,

enter patient search parameters and click on the Search button

• Full and partial matches against patient name, Medicaid ID, SSN, and Hawaii State ID

ePASRR Application—Search for Patients (cont.)

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• Results from search will appear in a grid• Select the patient you are looking for based on

the returned values

ePASRR Application—Add Patients

• If no patient matches the search criteria select Click here to add patient

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Add Patient

• Required fields are marked with (*)

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ePASRR Application—Packet Creation

• Once existing patient found or new patient added, create an electronic PASRR packet.

• Two options:– Create a New 1178– Copy Existing 1178 (limited to previous

submission)

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ePASRR Application—Packet Creation (cont.)

• Key features of 1178 online form– Hyperlink to list of PASRR Applicable Diagnoses;

launches PDF file• Click on embedded link: Major Mental disorder and/or

Substance Related disorder

– Validation checks to prevent erroneous entries– Logical edits to enable/disable sections based on

prior responses—i.e., Part C categorical determinations, need to complete Level 2 PASRR forms

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• Required fields– Primary diagnosis– Referral Source– Part A & B– Part C, only if any

question in Part A or Part B is marked “Yes”

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• If all answers to Part A and Part B are “No,” user will be prompted to enter the name of the screener, title/degree, date signed, and time signed

• Click on the Complete Form button

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• If any answers in Part A and/or Part B are “Yes,” user will be prompted to complete Part C

• The determination section is automatically entered based on Part C selections

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• Enter the name of the screener, title/degree, date signed, and time signed

• Click on the Complete Form button

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ePASRR Application—Packet Management

• Patient Management—Packet Management

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ePASRR Application—Packet Management (cont.)

• Multiple sections based on specific packet– Referring Entity Contact Information– Level 1 (PASRR Form 1178)

• View and print forms• Attach supporting documentation• Finalize Level 1 documentation

– Complete Level II Evaluation(s), if required

• Select nursing facilities for patient placement

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• Referring Entity Contact Information– Document key contact and information for facility– Click on + to expand, and select Edit to enter

information

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• Level 1 (PASRR Form 1178)– Preview and Print completed 1178– Upload supporting documentation

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• Level II Evaluations– If the DHS 1178 Level I is positive for SMI1 and/or

ID2/DD with no Categorical Determinations, Level II sections enabled• Level 2 Packet—AMHD• Level 2 Packet—DDD

– Application will automatically identify which Level II evaluation is required based on answers to the DHS 1178

42 1. Seriously Mentally Ill2. Intellectual Disabilities

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ePASRR Application—Packet Management(cont.)

PASRR Packet Creation

• Level II Evaluation Process– Complete all applicable forms and submit to

AMHD/DDD for Level II evaluation• Packet = Pending Level 2 Determination

– AMHD/DDD can defer ePASRR packet for additional information

• Packet = Level 2 Deferred• Includes note detailing reasons for deferment• Upload/add requested information and resubmit

– AMHD/DDD make determination; notification to referring entity

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Level II Review

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ePASRR Application—Level II Review

• Level 2 Notes section– If additional information is required to complete

Level II review, enter a note detailing the information to be requested and defer the ePASRR packet to the original submitter

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ePASRR Application—Level II Review (cont.)

• Level 2 Notes section– Type note into text box; click on the Add Note button

• Date/time and user name will be added automatically

– Click on the Defer to Level 2 Submitter button.

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1.

2.


• Level 2 Notes section– Packet status will change to Level II Deferred, and

will return to the submitter’s queue (In Progress)– Referring entity can update/upload the requested

information, and resubmit the PASRR Packet to AMHD/DDD

– Updated packet will display in Patient Packet grid in a Pending Level II Determination status

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• Once determination is finalized, user can view determination form and/or letter.

• Referring entities must submit final determination letter to patients and physician.

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Patient Placement

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ePASRR Application—Patient Placement

• Select nursing facilities to review patient information for potential admission

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ePASRR Application—Patient Placement (cont.)

• Patient Placement– Records are visible to selected facilities for 7 days– Once the patient is accepted at a facility, the

hospital/referring entity will select assign the designated nursing facility and complete the packet.

– The assigned nursing facility will now have access to view the patient’s PASRR packets.

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ePASRR Application—Patient Placement (cont.)

• Select nursing facilities to review patient information for potential admission

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ePASRR Statuses

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ePASRR Status Values—PASRR Packets

PASRR Packet Status Description

L1 in Progress 1178 is being created

L2 in Progress AMHD and/or DDD forms are being completed

L2 Deferred Level II packet has been sent back to referring entity for more information

Pending Placement Once all Level I and Level II (if required) processes are completed

Packet Complete Patient has been assigned to a nursing facility

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ePASRR Status Values—Level II Packets

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Level II Packet Status Description

L2 in Progress Remains in this status until referring entity submits packet for determination

Pending L2 Determination Waiting for determination from AMHD/DDD

L2 Deferred Level II packet has been sent back to referring entity for more information

L2 Complete Level II determination has been completed

ePASRR Status Values—Level II Forms

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Level II Form Status Description

Required Default status for most Level II forms

Optional Default status for some Level II forms

In Progress User has saved progress on the form

Complete User has finalized the form

DHS 1137 Monthly Census

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DHS 1137 Census Submission

• Access limited to nursing facilities

• Able to direct data enter and/or upload monthly census reports

• Access by selecting Submit Census (DHS 1137) in the right navigation bar

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DHS 1137 Census Submission (cont.)

• Nursing Facility name will automatically generate based on user login information

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• User selects Edit Form to prepare monthly census report


• Upload DHS 1137 form– User selects Browse to find the correct file and

then selects Upload

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• Resident information will be uploaded and visible– File must be submitted on official spreadsheet– File must be completed correctly

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• User can Edit or Delete resident information• Admissions can also be entered manually by

selecting + Add Resident

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• Once the Census Report is completed, the user selects Complete and a date/time stamp will be applied.

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• Census reports in Complete Status can be viewed by the facility but not changed.

• If the facility needs to make changes, HSAG will need to be contacted to change the form status to In Progress.

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• HSAG will monitor submission of nursing facility census reports – Report: Missing completed 1137 by NF– Generates a list of nursing facilities that do not

have an 1137 completed by the specified due date

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• Census Submission StatusesCensus (DHS 1137) Status Description

Not Started Form has not been started

In Progress User has saved progress on the form

Complete User has finalized the form

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Quarterly PASRR Compliance Reviews

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Compliance Reviews

• HSAG performs 500 reviews annually• Sample generated from nursing facility census

reports submitted to ePASRR– Sampling protocol

• Facilities on 100 percent review• Residents with categorical determinations• At least one admission from each facility

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Compliance Reviews (cont.)

• Quarterly census report compliance review statusesCompliance Review Status Description

Not Started Quarterly review sample has not been created yet

Generating Sample Sample being created from submitted DHS 1137 census reports

Accepting Submissions Sample has been generated and HSAG is currentlyaccepting medical record submissions

Reviews Complete All PASRR reviews have been completed

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Compliance Reviews (cont.)

• Generation of quarterly review sample– Transition from MQD to HSAG– Based on data uploaded by nursing facility to ePASRR

• Notification banner in ePASRR when sample ready• Notification email sent to contact person at each

nursing facility • Nursing facilities will be able to view sample and

upload requested medical records• Existing Compliance Review Audit Tool will be

integrated with ePASRR

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Status Descriptions

• Quarterly Census review sampling statusesRecord Review Status Description

Upload Records This record is part of the selected review period and needs supporting documentation/records uploaded

Ready to Submit Files have been uploaded and are being finalized before submitting to HSAG for review

Submitted Record has been submitted to HSAG and is currently being reviewed

Complete Record has been reviewed

Update RecordsRecord has been submitted to HSAG but needs additional clarification or documentation. Sent back to NF for updates

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Technical Support

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Technical Support

• Email: [email protected]• Call the HSAG Hawaii Office

– 7:45 a.m. to 4:30 p.m. (HST) Monday–Friday– 808.941.1444

• Call HSAG Arizona Application Support Line– 8 a.m. to 4 p.m. (MT) Monday–Friday– Voicemails left will be emailed to support staff

which is monitored 24/7– 866.316.6974

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mailto:[email protected]

Questions?

Pilot Testing begins December 11, 2017

Tom Miller - [email protected] Marsh - [email protected]

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epasrr training - hawaii: home · epasrr training for hospitals, nursing facilities, and community...

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