Preadmission Screening and Resident Review

Preadmission Screening and Resident Review (PASRR) ensures sure that people are placed in the appropriate environment when they need intensive treatment and services.

In brief, PASRR requires all applicants to Medicaid-certified nursing facilities be assessed to determine whether they might have an intellectual disability or mental illness. This is called a Level I screen. The purpose of a Level I screen is to identify individuals whose total needs require that they receive additional services for their intellectual disabilities or serious mental illness. Individuals who test positive at Level I are then evaluated in depth to confirm the determination of an intellectual disability or mental illness for PASRR purposes. This is a Level II screen. This assessment produces a set of recommendations for necessary services that are meant to inform the individual's plan of care.

PASRR Regulations

On November 30, 1992, the federal Health Care Financing Administration (HCFA), now the Centers for Medicare and Medicaid Services (CMS), published final rules to implement Preadmission Screening and Annual Resident Review (PASRR) requirements for all current and prospective nursing facility residents. The regulations are published at 42 CFR Parts 405, 431, 433, and 483.

PASRR requirements apply only to Medicaid-certified nursing facilities, and do not apply to Medicare-only skilled nursing facilities (SNFs), intermediate care facilities for individuals with intellectual disabilities (ICFs/IID), or community-based residential facilities (CBRFs).

Purposes of PASRR

  • Evaluate individuals seeking admission to nursing facilities and current nursing facility residents to determine if they have a serious mental illness or a intellectual disability.
  • Identify the individual’s strengths and needs.
  • Determine if the individual needs specialized psychiatric rehabilitation services to address his/her mental illness issues or specialized services to address his/her mental illness or intellectual disability issues.
  • Determine if the individual needs placement in a nursing facility versus placement in an inpatient psychiatric hospital, institution for mental diseases (IMD), intermediate care facility for individuals with intellectual disabilities (ICFs/IID), or a community setting (e.g., group home).
  • Notify the client or the client’s legal representative and other appropriate parties of the results of the evaluations and the determinations.

For More Information

Donna Wrenn
PASRR Administrator
Division of Care and Treatment Services
Wisconsin Department of Health Services
1 West Wilson Street, Room 851
P. O. Box 7851
Madison, WI 53707-7851
608-266-7072 - Desk
608-267-7793 - Fax

Last Revised: May 23, 2018