441—81.7 (249A) Continued review.
	 81.7(1) Level of care. The IME medical services unit shall review Medicaid members’ need of continued care in nursing facilities, pursuant to the standards and subject to the appeals process in subrule 81.3(1).
	 81.7(2) PASRR. Within the fourth calendar quarter after the previous review, the PASRR contractor shall review all nursing facility residents admitted pursuant to paragraph 81.3(3)“c” to determine:
	  a.   	 Whether nursing facility services continue to be appropriate for the resident, as opposed to care in a more specialized facility, and
	  b.   	 Whether the resident needs specialized services for mental illness or mental retardation as described in paragraph 81.3(3)“b.”
This rule is intended to implement Iowa Code sections 249A.2(1), 249A.3(3), and 249A.4.
[ARC 8445B, IAB 1/13/10, effective 12/11/09; ARC 9726B, IAB 9/7/11, effective 9/1/11; ARC 9888B, IAB 11/30/11, effective 1/4/12]