Nursing homes/healthcare facilities must promptly notify the state mental health authority or state intellectual disability authority of any significant changes in the mental or physical condition of a resident who has a mental disorder or intellectual disability. This is part of the Preadmission Screening and Resident Review (PASARR) process, which is a federal requirement to ensure that individuals with a mental disorder or intellectual disabilities are not inappropriately placed in nursing homes for long term care. A significant change is defined as a major decline or improvement in a resident's status that will not normally resolve itself without intervention by staff or by implementing standard disease-related clinical interventions, impacts more than one area of the resident's health status, and requires interdisciplinary review and/or revision of the care plan. Nursing homes must notify the SMH/ID authority of significant changes independent of the findings of the SCSA, and must refer to the state PASARR program requirements for specific procedures. Facilities must also complete a SCSA when the Interdisciplinary Team (IDT) has determined that a resident meets the significant change guidelines for either improvement or decline. This notification process will help ensure that individuals with a mental disorder or intellectual disabilities continue to receive the care and services they need in the most appropriate setting.

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