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The
Indiana Pre-Admission Screening Program (PAS) was
started by the State of
Indiana
on April 30, 1983. The primary purpose of this
program is to assure that before an individual is placed
in an
Indiana
nursing facility alternatives to long-term care such as
home and community services have been explored.
Individuals are helped to stay at home by finding and
assisting them to access available in-home and community
services necessary to avoid or delay nursing facility
placement. The PAS focuses on an individual’s
medical needs and determines if an individual meets the
Level of Care criteria required by
Indiana
for nursing facility placement.
This page contains the information that health care
professional need in order to complete the PAS process.
For consumer information on PAS please dial
812-432-6200.
PAS
Forms
State IPAS and PASSR
Manual
IPAS Reference
Guide
45278
Dr Cert for LTC and Physical Exam Level
II
45932
Categorical Determination for Short Term NF Care
47182
Dementia Checklist
Eligibility
Screen
IPAS Information
Sheet
Physician
Cert. for LTC Service Form 450B
PAS App for Long Term Care
Services
PAS Indiana PASRR Program Screen for
Depression
PAS Level
1 Identification Eval.Criteria Cert for LTC Services
Statement for Freedom of
Choice
Form 011 PAS Emergency
Intake
Form 026 Nursing Facility Extension
Request
Form 027 PAS Exempted Hospital Discharge
Documentation
Pre-Admission
Screening Guide for Health Care Professionals
Form 014 Do Not Agree
Statement
PASARR
Determination For Short-Term NF Care Certification
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