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 was put into federal law for three purposes:
- To make sure people with mental illnesses in Medicaid-funded nursing homes are being effectively diagnosed and treated
- To make sure those with mental illness or a developmental disability only (and no major physical problems), are not being warehoused in nursing homes
- To make sure 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 has two levels of assessment or evaluation. Level I is made up of demographic information, medical, psychiatric and developmental diagnosis. It also serves to document if and when 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 the nursing care services needed to meet the person’s medical needs. This broad 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, they receive an in-depth evaluation of their 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 watched by the State Bureau of Medicare/Medicaid Program Certification and Resident Assessment, which provides oversight and approves payment to the nursing facility from Medicaid. This helps provide 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, no matter how the individual resident will be paying for their nursing facility stay.