epasrr Training for Hospitals, Nursing Facilities, and Community Agencies Tom Miller, MA Executive Director, State & Corporate Services Elizabeth Marsh, RN, BSN, MPH Associate Director, State & Corporate Services 1
Agenda Overview of PASRR 1 Process Navigating the epasrr application Account registration, logging in, searching for a patient, and PASRR Packet Creation Nursing facility placement Nursing facility Level 2 submission Submitting monthly DHS 1137 2 census reports Integrating PASRR compliance reviews Accessing technical support 2 1. Preadmission Screening and Resident Review 2. Department of Human Services 1137
3 Overview of the PASRR Process
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 4
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 AMHD 1 /DD 2 Level II determinations Patient placement in nursing facility Nursing facility bed status Nursing facility DHS 1137 census submission PASRR quarterly compliance reviews Reports 5 1. Adult Mental Health Division 2. Developmental Disabilities
Overview of the PASRR Process 6
User Roles in epasrr Role-based access determined by user responsibilities Hospital Nursing Facility AMHD DDD 1 MQD 2 HSAG Admin 7 1. Developmental Disabilities Division 2. MedQUEST Division (State of Hawaii Medicaid Agency)
8 Registering for an epasrr Account
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 9
Account Registration (cont.) User Registration Name, Email, and Phone Number Provider Type Facility Click on the Register button when all fields are completed 10
Account Registration (cont.) 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 11
Account Registration (cont.) Registration approval email Click on Click Here link to be redirected to the Account Registration page 12
Account Registration (cont.) 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 13
Account Registration HILOC account password synchronization If you change your password in epasrr, it will automatically change your password in HILOC If you change your password in HILOC, it will automatically change your password in epasrr. Active HILOC accounts as of 1/4/18 will be transferred to epasrr Use the same email and password to login to both applications Do not need to register for an epasrr account 14
15 Accessing the epasrr Application
Accessing epasrr Steps to access the epasrr application 1. Open Web browser and enter https://epasrr.hsag.com in the address bar 2. Enter your User Name and Password; click on the Login button 16
Accessing epasrr (cont.) Secure Login screen 17
Accessing epasrr (cont.) Steps to access the epasrr application 3. Two Factor Authentication Federal regulations require secondary authentication to confirm user access Retrieve the 6-digit security code from the email account used to register for epasrr access 18
Accessing epasrr (cont.) Steps to access the epasrr application 3. Two Factor Authentication Sample email 19
Accessing epasrr (cont.) Steps to access the epasrr application 3. Two Factor Authentication Once authentication code sent, the User Authentication screen will display Enter security code and click on the Submit button 20
Accessing epasrr (cont.) Steps to access the epasrr application 4. 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 21
Accessing epasrr (cont.) epasrr User Agreement 22
23 The epasrr Application
Accessing epasrr Home Page Hospital/Community Agency View 24
epasrr Application Home Page 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 25
epasrr Application Home Page PASRR Packet Queue 26
epasrr Application Home Page Right navigation bar Role-based list of potential actions Feedback Search for Patients Reports Submit Census (DHS 1137) PASRR Review Resources & instructions 27
epasrr Application Search for Patients 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 28
epasrr Application Search for Patients (cont.) Results from search will appear in a grid Select the patient you are looking for based on the returned values 29
epasrr Application Add Patients If no patient matches the search criteria select Click here to add patient 30
Add Patient Required fields are marked with (*) 31
epasrr Application Packet Creation Once existing patient found or new patient added, create an electronic PASRR packet. Hospital/Community Agency have two options: Create a New 1178 Copy Existing 1178 (limited to previous submission, however future release will expand this capability) 32
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 33
epasrr Application Packet Creation (cont.) Required fields Primary diagnosis Referral Source Part A & B Part C, only if any question in Part A or Part B is marked Yes 34
epasrr Application Packet Creation (cont.) 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 35
epasrr Application Packet Creation (cont.) 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 36
epasrr Application Packet Creation (cont.) Enter the name of the screener, title/degree, date signed, and time signed Click on the Complete Form button 37
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 38
epasrr Application Packet Management (cont.) Referring Entity Contact Information Document key contact and information for facility Click on + to expand, and select Edit to enter information 39
epasrr Application Packet Management (cont.) Level 1 (PASRR Form 1178) Preview and Print completed 1178 Upload supporting documentation 40
epasrr Application Packet Management (cont.) Level II Evaluations If the DHS 1178 Level I is positive for SMI 1 and/or ID 2 /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 41 1. Seriously Mentally Ill 2. Intellectual Disabilities
epasrr Application Packet Management Patient Management Packet Management 42
epasrr Application Packet Management (cont.) 43
epasrr Application Packet Management (cont.) 44
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 45
46 Level II Review
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 47
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. 1. 2. 48
epasrr Application Level II Review (cont.) 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 49
epasrr Application Level II Review (cont.) 50
epasrr Application Level II Review (cont.) Once determination is finalized, user can view determination form and/or letter. Referring entities must submit final determination letter to patients and physician. 51
52 Patient Placement
epasrr Application Patient Placement Select nursing facilities to review patient information for potential admission 53
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 hits Select to assign the designated nursing facility and then completes the packet by selecting Complete Packet. The assigned nursing facility will now have access to view the patient s PASRR packets. 54
epasrr Application Patient Placement (cont.) Select nursing facilities to review patient information for potential admission 55
epasrr Application Patient Placement (cont.) Select nursing facilities to review patient information for potential admission 56
57 epasrr Statuses
epasrr Status Values PASRR Packets PASRR Packet Status L1 in Progress L2 in Progress L2 Deferred Pending Placement Packet Complete Description 1178 is being created AMHD and/or DDD forms are being completed Level II packet has been sent back to referring entity for more information Once all Level I and Level II (if required) processes are completed Patient has been assigned to a nursing facility 58
epasrr Status Values Level II Forms Level II Form Status Required Optional In Progress Complete Description Default status for most Level II forms Default status for some Level II forms User has saved progress on the form User has finalized the form 59
epasrr Status Values Level II Packets Level II Packet Status L2 in Progress Pending L2 Determination L2 Deferred L2 Complete Description Remains in this status until referring entity submits packet for determination Waiting for determination from AMHD/DDD Level II packet has been sent back to referring entity for more information Level II determination has been completed 60
61 Nursing Facility Role
Nursing Facility Role Home Page Nursing Facility View 62
Nursing Facility Role Packet Options Nursing facilities have two options for creating a Level II packet in epasrr: Level 2 w/epasrr 1178 Use this option if the Level I you used to admit the patient with is in the epasrr application Level 2 w/o epasrr 1178 Use this option if the Level I you used to admit the patient with is a hard copy and not in the epasrr application 63
Nursing Facility Role Packet Options 64
Nursing Facility Role Packet Options Level 2 w/ epasrr 1178 65
Nursing Facility Role Packet Options Level 2 w/o epasrr 1178 66
67 DHS 1137 Monthly Census
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 68
DHS 1137 Census Submission (cont.) Nursing Facility name will automatically generate based on user login information User selects Edit Form to prepare monthly census report 69
DHS 1137 Census Submission (cont.) Upload DHS 1137 form User selects Browse to find the correct file and then selects Upload 70
DHS 1137 Census Submission (cont.) Resident information will be uploaded and visible File must be submitted on official spreadsheet File must be completed correctly 71
DHS 1137 Census Submission (cont.) User can Edit or Delete resident information Admissions can also be entered manually by selecting + Add Resident 72
DHS 1137 Census Submission (cont.) Once the Census Report is completed, the user selects Complete and a date/time stamp will be applied. 73
DHS 1137 Census Submission (cont.) 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. 74
DHS 1137 Census Submission (cont.) 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 75
DHS 1137 Census Submission (cont.) Census Submission Statuses Census (DHS 1137) Status Not Started In Progress Complete Description Form has not been started User has saved progress on the form User has finalized the form 76
77 Quarterly PASRR Compliance Reviews
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 78
Compliance Reviews (cont.) Quarterly census report compliance review statuses Compliance Review Status Not Started Generating Sample Accepting Submissions Reviews Complete Description Quarterly review sample has not been created yet Sample being created from submitted DHS 1137 census reports Sample has been generated and HSAG is currently accepting medical record submissions All PASRR reviews have been completed 79
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 80
Status Descriptions Quarterly Census review sampling statuses Record Review Status Upload Records Ready to Submit Submitted Complete Update Records Description This record is part of the selected review period and needs supporting documentation/records uploaded Files have been uploaded and are being finalized before submitting to HSAG for review Record has been submitted to HSAG and is currently being reviewed Record has been reviewed Record has been submitted to HSAG but needs additional clarification or documentation. Sent back to NF for updates 81
82 Technical Support
Technical Support Email: epasrrsupport@hsag.com 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 83
Questions? epasrr for all islands begins February 1, 2018 Tom Miller - tmiller@hsag.com Elizabeth Marsh - emarsh@hsag.com Desiree Mizuno dmizuno@hsag.com 84