About Us

Services

Long Term Care
> Facilities
> Services
> Complaints

Federal law requires people seeking admission to Medicaid certified nursing homes to be "screened" before admission to determine if they are mentally ill or mentally retarded. The purpose of the law is to prevent mentally ill or retarded persons who need treatment or these conditions from being placed in nursing homes unless nursing home care is required.

Everyone seeking admission to a Medicaid certified nursing home, regardless of condition or source of payment for care, must go through this screening process. Medicaid payments will be withheld from nursing homes unless all residents admitted since January 1, 1989 has been "pre-screened."

The same federal law also requires that current residents of Medicaid certified nursing homes be evaluated once a year to determine if they are mentally ill or retarded and if nursing home care is required. Except for certain circumstances, mentally ill or retarded nursing home residents who do not need nursing home care will be required to move to other housing. Moving will be arranged by the Michigan Department of Mental Health.

The following information summarizes interim rules developed by the State of Michigan to implement the federal law. It is likely that there will be future changes in these rules.

Under the federal law, you are considered to be mentally ill if you have a "serious" mental illness. A "serious" mental illness has not yet been defined by the government. An example of a serious mental illness is schizophrenia.

No! The federal law specifically excludes Alzheimer’s disease and other types of dementia from the definition of mental illness. When the screening requirements were established, congress stated that it did not intend to prevent individuals with Alzheimer’s disease and related disorders from obtaining nursing home care. However, a diagnosis of Alzheimer’s disease must be confirmed in a clinical examination by a physician.

The State of Michigan has developed a two-level process for conducting the screening. The first level (Level I screen) requires a physician, physician assistant, registered nurse, certified or registered social worker, or psychologist to complete a form (MSA-3877) which seeks to determine if you have a current diagnosis, recent history or symptoms suggestive of either mental illness or mental retardation.

If you do not have any of these conditions or symptoms, it will be noted on the form and the form will be made part of your nursing home record when you are admitted. No further action is required by anyone. You should obtain a copy of the form for your records.

If you have one of the specified conditions or symptoms, a physician must certify whether you qualify for an exception allowing admission to a nursing home. You qualify for an exception if:

• You have a primary diagnosis of dementia, such as Alzheimer’s disease; or
• You are being discharged from a hospital and need 30 days or less of convalescent
• care for the condition treated by the hospital; or
• You are in a coma.

If you meet one of these conditions, it must be certified by a physician on another form (DSS-3878). After the form is completed, you may be admitted to a nursing home of your choice. A copy of the form will be included in your nursing home record and another copy will be sent to the local community mental agency. Request a copy of the completed form for your records.

No further action is required. If you mental health status cannot be evaluated due to your medical condition (such as a severe stroke), the screening can be delayed. You may be admitted to a nursing home on a conditional basis for thirty days. In this situation, the nursing home is responsible for completing the screening process after you are admitted.

In this situation, the State requires another evaluation (Level II screen) to determine if you qualify for nursing home care. This evaluation must be conducted without charge by the community mental health agency in your area. If you do not know how to contact the community medical health agency in your county, contact your local Citizens for Better Care office for assistance.

If you need specialized services for mental illness or mental retardation and to not require continuous nursing care or medical supervision, the community mental health service will not approve your admission to a nursing home. But it should help you arrange needed treatment. However, if you do require nursing care, the community mental health agency may determine that you qualify for admission to a nursing home. If so, another form (DDS-3879) will be completed and sent to the nursing home you plan to enter. You or your legal guardian should also receive a copy and keep it for your records.

The law requires all residents of Medicaid certified nursing homes be evaluated at least annually to determine if they are mentally ill or mentally retarded. The evaluation uses the same forms and procedures that re used to screen people seeking admission to a nursing home.

Mentally ill or mentally retarded residents who have lived in a nursing home for at least 30 months at the time of the evaluation may be able to remain in the nursing home even if they do not require nursing home services. Other residents who are determined to be mentally ill or retarded and who do not require nursing home care will eventually be required to move to other housing. However, residents will not be required to move until Michigan Department Bureau of Health Services establishes appropriate alternative living arrangements.

Nursing home residents must be screened or evaluated at least once every twelve months. Residents who are readmitted to a nursing home from the hospital are not required to undergo another screening.

Although federal law gives you the right to appeal decision made in the screening process, the State of Michigan has not yet established a formal appeals process. To request an appeal, you should contact the Michigan Department of Mental Health at (517) 335-0188. Appeal should be sent to:

You also have the right to file an appeal with the Michigan Department Bureau of Health Systems if the screening process affects your eligibility for Medicaid coverage.

If you have questions or are experiencing problems concerning the pre-admission screening process, please contact your local Citizens For Better Care office for further assistance.

Rev: 92, 96, 97, 98, 99, 03/00, 10/02, 04/04