OBRA PASRR Occupational Therapist Evaluator

Principal Duties And Responsibilities

• Provides outreach mental health assessments pursuant to PASRR regulations.
• Performs and documents PASSR initial examinations.
• Determines if a nursing facility is the most appropriate care setting or if the individual has a need for specialized services.
• Uses client’s social history, medical reports, patient care, plan of treatment, current physician’s orders, current medications and ongoing therapy reports to make medical determinations.
• Identifies and documents a client’s functional goals, anticipated progress and plans for re-evaluation, discharge, or admission to nursing care facility.
• Plans, prepares and carries out individually designed programs of therapy to restore, improve or maintain functions, alleviate pain and progress to maximize daily living.
• Affirms and documents the patient's physical, communication and cognitive skills to create or validate a specific treatment plan for each patient based on individual needs.
• Gathers data pertinent to a client’s functioning ability and history.
• Conducts evaluations prior to nursing facility admissions.
• Contacts providers, nursing facility staff and others to obtain information and records of clients to conduct a comprehensive clinical review of cases and to make final assessments and determinations.
• Makes determinations and service recommendations, authorizes services and monitors service plans.
• Sets forth formal recommendations and reports that contain clinical summaries.
• Determines medical necessity and the need for specialized services for individuals with serious mental illnesses seeking transfer to nursing facilities.
• Documents significant changes that signify the need for an updated evaluation.
• Completes evaluations on an individualized basis in accordance with federal guidelines and regulations.
• Formulates, disposes of and recommends treatment for clients.
• Communicates all evaluation findings to clients and guardians.
• Responds to Level II referral assignments within contract guidelines as evidenced by submission of all assessments within 7 days of assignments.
• Responds to clinical matters as directed by Supervisors.
• Attends clinical meetings as scheduled by Supervisors.
• Maintains individual records, HIPAA regulations and client confidentiality.

KNOWLEDGE, SKILLS, AND ABILITIES (KSA’s)

• Knowledge of DWIHN policies, procedures and practices.
• Knowledge of the DWIHN provider network and community resources.
• Knowledge of the Michigan Mental Health Code.
• Knowledge of MDHHS policies, rules, regulations and procedures.
• Knowledge of Federal policies, rules, regulations and procedures as it relates to DWIHN.
• Knowledge of behavioral health and mental health principles and practices.
• Knowledge of the Michigan Medicaid Provider Manual.
• Knowledge of Occupational Therapy principles and practices.
• Knowledge of Occupational Therapy assessments as it relates to PASSR assessments.
• Knowledge of MHWIN.
• Knowledge of and ability to use screening and assessment tools for behavioral health services.
• Knowledge of Medical Necessity Criteria for Behavioral Health Services.
• Knowledge of the American Society of Addiction Medicine Patient Placement Criteria.
• Knowledge of Integrated Care principles and practices.
• Knowledge of the Omnibus Budget Reconciliation Act (formerly known as the Nursing Home Reform Act of 1987) (OBRA) rules, regulations and requirements.
• Knowledge of Pre-Admission Screening and Resident Review (PASRR) guidelines.
• Knowledge of the 3877/3878 database.
• Knowledge of mental health as it relates to the aging population.
• Knowledge of nursing home practices and procedures.
• Knowledge of Level 1 and Level II Assessments based on the MDHHS PASRR Operation Manual Guidelines for completing a comprehensive Level II evaluation.
• Knowledge of the Diagnostic Formulation of Level II Assessments based on the DSM criteria.
• Knowledge of diagnostic formulation, disposition and treatment recommendations.
• Knowledge of ICD 9, CPT Codes, DSM-IV Statistical Manual or most current diagnostic edition.
• Knowledge and understanding of mental diagnoses, behaviors and/or prescribed medications.
• Knowledge of developmental issues in the older adult population.
• Knowledge of how mental illness impacts older adults.
• Computer skills (Word, Excel, Access, Power Point, Outlook, Teams).
• Diagnostic skills.
• Assessment skills.
• Evaluation skills.
• Organizational skills.
• Planning skills.
• Reasoning skills.
• Problem Solving skills.
• Interpersonal skills.
• Implementation skills.
• Written communication skills.
• Accuracy and detailed oriented skills.
• Teamwork Skills.
• Relationship-building skills.
• Ability to communicate orally.
• Ability to communicate in writing.
• Ability to work effectively with others.
• Ability to work with an ethnically, linguistically, culturally, economically and socially diverse population.
• Judgement/Reasoning ability.

Required Education

A Master’s Degree in Occupational Therapy or a closely related field from a recognized college or university.

Required Experience

Three (3) years of full-time paid professional experience performing Occupational Therapy evaluations.

Required License(s)

A Valid State of Michigan license as an Occupational Therapist. A Valid State of Michigan Driver’s License with a safe and acceptable driving record.