Specialized Nursing Homes - OBRA

The Office of Specialized Nursing Homes/OBRA Programs was originally established in response to the provisions of the federal Omnibus Budget Reconciliation Act (OBRA) of 1987, which amended the Medicaid program requirements for nursing facilities. Its primary function has been to assure the implementation of those provisions of OBRA which address the relationship of nursing facilities to persons who are seriously mentally ill or have an intellectual/developmental disability (ID/DD).

The preadmission screening/annual resident review (PASARR) required by OBRA is the major function of the office. Under the PASARR program, all persons seeking admission to a nursing facility who are seriously mentally ill or have an intellectual/developmental disability are required to be evaluated to determine whether the nursing facility is the most appropriate place for them to receive services and whether they require specialized behavioral health services. In addition, persons residing in a nursing facility who are seriously mentally ill or have an intellectual / developmental disability are required to undergo a similar review annually or when there is a significant change in condition to determine whether they continue to require the services of a nursing facility or whether they require specialized services.

This review process begins with the completion of a screening form, usually by a nursing facility or a hospital. If the responses to the questions on the form indicate the presence of a mental illness or an intellectual/developmental disability (or a related condition), the person is referred to the local community mental health services program to assess if a comprehensive evaluation is needed. This evaluation and the evaluator's recommendation are reviewed by this office and a determination made as to whether the person is appropriate for nursing facility admission/stay and whether specialized services are required. Persons evaluated or their legal representative may appeal the determination if they disagree.

In addition to the PASARR determination process, the office handles contracts and billings with community mental health services programs for the PASARR evaluation process. The Office also provides technical assistance to local community health services programs in providing behavioral health services to persons residing in nursing facilities.

Contact:  For information regarding OBRA programs, call 517-241-5881.