Pre-admission Consultation Requirements (PAC)
 Revised Requirements - Effective Immediately

PDF Version of DQA 11-013  (PDF, 53 KB)

Pre-admission Consultation Requirements (PAC) Revised Requirements - Effective Immediately

Overview:

This memo describes changes in the requirements for community based residential facilities (CBRFs), nursing homes and residential care apartment complexes (RCACs) to make referrals and provide information to prospective residents.  The information and referral requirements are often referred to as Pre-admission Consultation (PAC).

Substantive revisions include:

• Facilities are not longer required to complete the Referral for Pre-admission Consultation, form F-62493, and submit the form to the local Aging and Disability Resource Center (ADRC).  The referral form will no longer be available on the DHS/DQA forms website.
• Facilities subject to PAC requirements must continue to provide a copy of the brochure, "Considering Assisted Living or a Nursing Home:  What You Should Know" to a prospective resident or his or her representative when they first provide information about the facility.  Provision of the brochure satisfies the requirement for the provision for information and for making a referral as required by Chapter 50 of the Wisconsin Statutes.
• A revised version of the PAC brochure is available on line at: http://www.dhs.wisconsin.gov/ltcare/adrc/professionals/
  programsservices/pac.htm. Individualized brochures, with local contact information, are available for each county.  Facilities should use this version of the brochure.  As before, facilities are responsible for printing and providing copies of the brochure to prospective residents.

Background

With the enactment of 2007 Wis. Act 20 PAC requirements went into effect on July 1, 2009 as part of the statewide transition to managed long term care and self-directed supports in Wisconsin's Medicaid waiver programs. These requirements are being revised based on experience with the program to date.

The revised PAC requirements apply to CBRFs in all Wisconsin counties and to nursing homes and RCACs in those counties where an Aging and Disability Resource Center (ADRC) is available. When an ADRC becomes available in a county, the PAC requirements for nursing homes and RCACs take effect. As of May 1, 2011, 59 of Wisconsin's 72 counties have an ADRC.

Requirements for Providers

Community-based Residential Facilities

Before an ADRC is available. CBRFs in counties operating with CIP/COP Medicaid Waivers are required to provide a copy of the brochure, "Considering Assisted Living or a Nursing Home: What You Should Know," to prospective residents or to their representative when they first provide information about the facility. Where there is no ADRC, the brochure will invite people to contact the county human service, social service or community programs department for pre-admission consultation.

After an ADRC is available. The requirement remains unchanged. CBRFs are required to provide a copy of the brochure, "Considering Assisted Living or a Nursing Home: What You Should Know," to prospective residents or to their representative when they first provide information about the facility. The brochure will invite people to contact the ADRC for PAC.

DQA staff will monitor for compliance with these requirements during survey. Failure to comply with these requirements may result in a citation and forfeiture of up to $500 for each violation. See Wis. Stat. § 50.035 (11) (a).

Nursing Homes and Residential Care Apartment Complexes

Before an ADRC is available. There is no requirement to refer prospective residents for pre-admission consultation prior to the availability of an ADRC in the county where the facility is located.

After an ADRC is available. Facilities are required to provide a copy of the brochure, "Considering Assisted Living or a Nursing Home: What You Should Know," to prospective residents or to their representative when they first provide information about the facility. The brochure will invite people to contact the ADRC for PAC.

DQA staff will monitor for compliance with these requirements during survey. Failure to comply with these requirements may result in a citation and forfeiture of up to $500 for each violation. See Wis. Stats. §§ 50.04 (5) (a) 3 and 50.034 (8) (a).

Implementation Status

PAC requirements apply to all CBRFs, regardless of whether an ADRC is available in the county where the facility is located.

The requirement for nursing homes and RCACs to provide information takes effect when an ADRC begins operation in the county where the facility is located. Counties where an ADRC currently operates are listed below. Start dates for new ADRCs will be made available through the DQA Publications on the DQA Listserv. To sign up to receive DQA Publications, go to: http://www.dhs.wisconsin.gov/rl_DSL/Listserv/signup.HTM.

Counties in which an ADRC currently operates (as of May 1, 2011):

Contact information of staff in DQA to answer questions

Questions from nursing homes should be directed to the Regional Field Operations Director for the region in which your facility is located. Regional contact information is located at: http://www.dhs.wisconsin.gov/rl_DSL/Contacts/reglmap.htm

Questions from CBRFs and RCACs should be directed to the Assisted Living Regional Director for the region in which your facility is located. Regional contact information is located at: http://www.dhs.wisconsin.gov/rl_DSL/Contacts/ALSreglmap.htm

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Last Updated: September 30, 2011