Pre-Admission Screening / Resident Review (PASRR)

Overview and Purpose

PASRR stands for Pre-Admission Screening/Resident Review and is part of the Federal Omnibus Budget Reconciliation Act. 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.

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