Pre-Admission Screening/Resident Review (PASRR)

PASRR stands for Pre-Admission Screening/Resident Review and is part of the Federal Omnibus Budget Reconciliation Act. The rules regarding the PASRR process are found in the Code of Federal Regulations Part 483, Subpart C, Volume 57, No. 230. This federal law was enacted for three purposes:

1. To ensure that people with mental illnesses in Medicaid-funded nursing homes are being adequately diagnosed and treated
2. To ensure that those with mental illness or a developmental disability only (and no substantial physical problems), are not being warehoused in nursing homes
3. To ensure that the federal government is not paying for long term care of the mentally ill or developmentally disabled in nursing homes that do not meet nursing facility criteria

  • The PASRR process consists of two levels of assessment or evaluation: Level I and Level II. The Level I contains demographic information, medical, psychiatric and developmental diagnoses. It also serves to document when and if a Level II is needed and is requested.
  • The PASRR Level II evaluation is an in-depth review of medical, social, and psychiatric history, as well as ADL functioning. It also documents nursing care services that are required to meet the person’s medical needs. This comprehensive evaluation is funded by federal money, which is managed separately by State mental health and Developmental disability authorities. There is no charge to the patient.
  • There are advantages to the patient because of the PASRR process. First, he/she receives an in-depth evaluation of his/her psychiatric status, which is reviewed by a psychiatrist. This service is provided at no cost to the patient. Second, recommendations made in the Level II are closely monitored by the State Bureau of Medicare/Medicaid Program Certification and Resident Assessment, which provide oversight and approves payment to the nursing facility from Medicaid. This helps to ensure better care and monitoring by staff in the nursing facility.
  • The need to complete the PASRR process is fairly specific and all nursing facilities that accept Medicaid as a primary payment must complete a Level I on every resident, regardless of how the individual resident will be paying for his/her nursing facility stay.

PASRR Web-based System Access

  • Click here to log into the secure, web-based PASRR system.
  • Click here to download instructions for creating a PASRR Login.
  • Click here to review the Code of Federal Regulations (CFR) for PASRR from the U.S. Government Publishing Office


  • Click here to request a Level One form.
  • Click here to download the 2014 Revised PASRR Level Two form.
  • Click here to download the Nursing Facility Update Form.

Local Contact Directories

  • Click here to access the Local PASRR and ID-RC Agencies by county.
  • Click here find the Local Mental Health Authority Agencies by county.
  • Click here to find helpful PASRR contacts

Training Resources

    Manuals and Instructions

    Understanding the PASRR Program
  • Click here to access the 2016 PASRR Training Manual.
  • Chapter 1-3 Level I Instructions
    Chapter 4-PHQ
    Chapter 5-Level II Information
    Chapter 7-Different Diagnosis
    Chapter 8-9 CFR-(Code of Federal Regulations)

How to use the PASRR System
  • Click here to view the 2016 PASRR System Manual for Evaluators.
  • Click here to view the 2016 PASRR System Manual for Nursing Facilities.

PowerPoint Presentations

  • Click here to view the 2016 PASRR Level I Training Presentation.

Important Memos

  • Click here for new contact information for ID-RC PASRRs
  • Click here for clarification on when to use the revised Level 1 form
  • Click here to access the Significant Change and Emergency PASRR Memo
  • Click here to access the revised Level I Form Memo
    • Other Helpful Materials

      • Click here to view the Frequently Asked Questions Memo