Specialized Nursing Homes - OBRA
The Office of Specialized Nursing Homes - OBRA Programs was originally established in response to the provisions of the federal Omnibus Budget Reconciliation Act (OBRA) of 1987, which amended the Medicaid program requirements for all nursing facilities. Its primary function has been to assure the implementation of those provisions of Preadmission Screening and Annual Review (PASRR) which address the relationship of nursing facilities to persons who are seriously mentally ill and/or have an intellectual/developmental disability (ID/DD).
The PASRR, required by OBRA, is the major function of this office. Under the PASRR program, all persons seeking admission to a nursing facility who are seriously mentally ill and/or have an intellectual/developmental disability are required to be evaluated to determine whether the nursing facility is the most appropriate place for them to receive services and whether they require specialized behavioral/mental health services. In addition, persons residing in a nursing facility who are seriously mentally ill and/or have an intellectual / developmental disability are required to undergo a similar review annually or when there is a significant change in condition to determine whether they continue to require the services of a nursing facility or whether they require specialized mental health services.
This review process begins with the completion of a screening form (Level I DCH-3877) usually by a nursing facility, hospital, or community agency/provider. If the responses to the questions on the form indicate the presence of a mental illness and/or an intellectual/developmental disability (or a related condition), the person is referred to the local community mental health services program (your local OBRA Coordinator) to assess if a comprehensive evaluation (Level II) is needed. This evaluation and the evaluator's recommendation are reviewed by the State OBRA office and a final determination is made as to whether the person is appropriate for nursing facility admission/stay and whether specialized services mental health care is required. The individual evaluated or their legal representative may appeal the determination if they disagree.
In addition to the PASRR determination process, the office handles contracts and billings with community mental health services programs for the PASRR evaluation process. The Office also provides technical assistance to local community health services programs in providing behavioral health services to persons residing in nursing facilities.
For questions or information regarding OBRA programs, call 517-241-5881 or via email:
The OBRA Helpdesk is available between 8:00am and 5:00pm Eastern time Monday through Friday. Messages will be responded to as quickly as possible or within 24 hours.
Electronic 3877/78 Application Training:
If you are a community agency in the State of Michigan and are looking to establish an account for facilitating the new electronic Level I (DCH-3877/78) application, please contact our office. Please provide the following information: Name, Facility Name, Address and a list of other facilities in your group if applicable.