1. A. The PAS instrument for an applicant or member who is EPD includes the following categories:

   1. 1. Intake information category. The assessor solicits intake information category information on an applicant’s or member’s demographic background. The components of the intake information category are not included in the calculated PAS score.

   2. 2. Functional assessment category. The assessor solicits functional assessment category information on an applicant’s or member’s:

      1. a. Need for assistance with activities of daily living, including:

         1. i. Bathing,
         2. ii. Dressing,
         3. iii. Grooming,
         4. iv. Eating,
         5. v. Mobility,
         6. vi. Transferring, and
         7. vii. Toileting in the residential environment or other routine setting;
      2. b. Communication and sensory skills, including hearing, expressive communication, and vision; and
      3. c. Continence, including bowel and bladder functioning.

   3. 3. Emotional and cognitive functioning category. The assessor solicits emotional and cognitive functioning category information on an applicant’s or member’s:

      1. a. Orientation to person, place, and time. In soliciting this information, the assessor shall also take into account the caregiver’s judgment; and

      2. b. Behavior, including:

         1. i. Wandering
         2. ii. Self-injurious behavior,
         3. iii. Aggression,
         4. iv. Resistiveness, and
         5. v. Disruptive behavior.

   4. 4. Medical assessment category. The assessor solicits medical assessment category information on an applicant’s or member’s:

      1. a. Medical conditions that have an impact on the applicant’s or member’s functional ability in relation to activities of daily living, continence, and vision;
      2. b. Medical condition that requires medical or nursing service and treatment;
      3. c. Medication, treatment, and allergies;
      4. d. Specific services and treatments that the applicant or member is currently receiving; and
      5. e. Physical measurements, hospitalization history, and ventilator dependency.

2. B. The assessor shall use the PAS instrument to assess an applicant or member who is EPD as specified in this Section. A copy of the PAS instrument is available from the Administration. The Administration uses the assessor’s PAS assessment to calculate three scores: a functional score, a medical score, and a total score.

   1. 1. Functional score:

      1. a. The Administration calculates the functional score from responses to scored items in the functional assessment and emotional and cognitive functioning categories. For each response to a scored item, a number of points is assigned, which is multiplied by a weighted numerical value. The result is a weighted score for each response.

      2. b. In the functional assessment matrix, all items in the following categories are scored according to subsection (C):

         1. i. Activities of daily living,
         2. ii. Continence,
         3. iii. Sensory,
         4. iv. Orientation, and
         5. v. Behavior.
      3. c. The sum of the weighted scores equals the functional score. The weighted score per item can range from 0 to 15. The maximum functional score attainable by an applicant or member is 166.

   2. 2. Medical score.

      1. a. In the medical assessment matrix, all items in the following categories are scored according to:

         1. i. Medical conditions as specified in subsection (C), and
         2. ii. Medical or nursing services and treatments in subsection (C).

      2. b. The Administration calculates the medical score based on the applicant’s or member’s:

         1. i. Diagnosis of Alzheimer’s, or dementia, or organic brain syndrome (OBS);
         2. ii. Diagnosis of paralysis; and
         3. iii. Current use of oxygen.
      3. c. The maximum medical score attainable by an applicant or member is 31.5.

   3. 3. Total score.

      1. a. The sum of an applicant’s or member’s functional and medical scores equals the total score.
      2. b. The total score is compared to the established threshold score as calculated under this Section. The threshold score is 60.
      3. c. As defined in R9-28-303, an applicant or member is determined at immediate risk of institutionalization if the total score is equal to or greater than 60.

3. C. The following matrices represent the number of points available and the respective weight for each scored item.

   1. 1. Table 1, Functional assessment points. The lowest value in the range of points available per item in the functional assessment category, zero, indicates minimal to no impairment. Conversely, the highest value indicates severe impairment.

   2. 2. Table 2, Medical assessment points. The lowest value in the range of points available per item in the medical assessment category, zero, indicates that the applicant or member:

      1. a. Does not have the scored medical condition,
      2. b. Does not need the scored medical or nursing services, or
      3. c. Does not receive the scored medical or nursing services.

Table 1. Functional Assessment

Table 2. Medical Assessment

Alzheimer’s, or OBS, or

Historical Note

New Section adopted by emergency action, subsection (A) effective June 30, 1995, subsection (B) effective September 1, 1995, pursuant to A.R.S. § 41-1026, valid for 180 days; entire Section filed as an emergency rule with the Secretary of State’s Office June 30, 1995 (Supp. 95-2). New Section adopted again by emergency action with changes effective January 2, 1996, pursuant to A.R.S. § 41-1026, valid for 180 days (Supp. 96-1). Emergency expired. New Section adopted effective January 14, 1997 (Supp. 97-1). Former Section R9-28-304 renumbered to R9-28-305; new Section R9-28-304 renumbered from R9-28-303 and amended by final rulemaking at 7 A.A.R. 5824, effective December 7, 2001 (Supp. 01-4). Amended by final rulemaking at 12 A.A.R. 4007, effective October 5, 2006 (Supp. 06-4). Amended by final expedited rulemaking at 28 A.A.R. 3303 (October 14, 2022), with an immediate effective date of September 23, 2022; the functional and medical assessment matrices following subsection (C)(2)(c) have been named Table 1 and 2 (Supp. 22-3).