Preadmission Screening and Resident Review

Preadmission Screening and Resident Review (PASRR) is a federal requirement established in 1987 to identify individuals with mental illness and/or intellectual developmental disability to ensure appropriate placement in the community or a nursing facility. 

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 Level II screen referral process​

​​As of March 1, 2020, Behavioral Consulting Services processes these screens. All referrals should be faxed to Behavioral Consulting Services. Use one of these fax numbers:

  • 262-376-0920
  • 262-376-0925
  • 262-376-0927
  • 262-376-0945

For help, call 262-376-1223 or email Do not email referrals. All referrals should be faxed.

In the event that you need to mail documents to Behavioral Consulting Services, use the following address.

Behavioral Consulting Services
PO Box 953
Grafton, WI 53024

Department of Health Services PASRR Email Mailbox

Send questions or concerns regarding PASRR to the Division of Care and Treatment Services. Provide information about the challenge you are experiencing and who should be contacted if a response is necessary. Identify any health or safety risks involved in the situation.


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.
Last Revised: November 9, 2020