COVID-19 impact on PASRR
The Wisconsin Preadmission Screening and Resident Review (PASRR) process remains in place. Federal law requires that all people requesting admission to a nursing facility must be screened to determine the presence of a mental illness and/or an intellectual disability. A PASRR Level I screen must be completed on every individual entering a Medicaid certified nursing facility. An individual suspected of having a mental illness and/or an intellectual disability should be referred for PASRR Level II screen. To prevent a backlog of screens, review all current or new residents to determine if a PASRR-related condition exists. Residents may be isolated in their rooms due to the COVID-19 pandemic, which may increase symptoms of anxiety and depression. Monitor residents carefully for mental health concerns and refer them for PASRR Level II screening as needed.
These resources are for professionals involved in Preadmission Screening and Resident Review.
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:
For help, call 262-376-1223 or email firstname.lastname@example.org. 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 Address
If you have questions or concerns regarding the PASRR Level II screen process, email 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 if any health or safety risks are involved in the situation.
These memos were issued by the Division of Mental Health and Substance Abuse Services (DMHSAS), the predecessor to the Division of Care and Treatment Services (DCTS). This guidance remains current and should be followed.
- 2015-04 Action: Wisconsin Preadmission Screening and Resident Review (PASRR) Process and Requirements (PDF) (County PASRR Liaisons (PDF))
- 2015-05 Action: Wisconsin Preadmission Screening and Resident Review (PASRR), Revision of the DDE-822 Form, Relabel The Form F-20822, and Revision of Policy (PDF)
Rules and regulations
- PASRR Regulations (42 CFR Part 483)
- Nursing Facility Regulations (42 CFR Part 483)
- ICF/MR Regulations (42 CFR Part 483)
- Subpart I (PDF)
- Federal State Operations Manual
Information on the Civil Rights of Institutionalized Persons Act.
- Wis. Stat. ch. 46 - Social Services
- See Wis. Stat. § 46.279 regarding restrictions on placements and admissions to intermediate and nursing facilities.
- See Wis. Stat. § 46.90 regarding the elder abuse reporting system.
- Note: The Division of Quality Assurance previously issued DQA Numbered Memo 2006-028 indicating nursing homes should file elder abuse reports with the applicable DQA Regional Office in lieu of contacting the county's designated agency. It is anticipated that this memo will be reissued soon.
- Wis. Stat. ch. 50 - Uniform Licensure
- See Wis. Stat. § 50.06 regarding certain admissions to facilities.
- Wis. Stat. ch. 51 - State Alcohol, Drug Abuse, Developmental Disabilities and Mental Health Act
- Wis. Stat. ch. 54 - Guardianships and Conservatorships
- See Wis. Stat. § 54.25 regarding duties and powers of guardian of the person.
- See Wis. Stat. § 54.48 regarding protective placement and protective services.
- See Wis. Stat. § 54.50 regarding temporary guardianships.
- See Wis. Stat. § 54.52 regarding standby guardianships.
- See Wis. Stat. § 54.54 regarding successor guardian.
- See Wis. Stat. § 54.68 regarding review of conduct of guardian.
- NOTE: Prior to the effective date of this chapter, which was December 1, 2006, all court orders granted full guardianship unless otherwise specifically noted by the court; after the effective date, wards retain all rights to make decisions expect as specifically identified by the court (limited guardianship)
- Wis. Stat. ch. 55 - Protective Service System
- See Wis. Stat. § 55.001 regarding declaration of policy.
- See Wis. Stat. § 55.043 regarding adult-at-risk agency.
- See Wis. Stat. § 55.055 regarding admissions initially made without court involvement.
- See Wis. Stat. § 55.08 regarding protective services or protective placements: standards.
- See Wis. Stat. § 55.12 regarding order for protective services or protective placement.
- See Wis. Stat. § 55.13 regarding emergency protective services.
- See Wis. Stat. § 55.135 regarding emergency and temporary protective placement.
- See Wis. Stat. § 55.14 regarding involuntary administration of psychotropic medication.
- See Wis. Stat. § 55.18 regarding annual review of protective placement.
- See Wis. Stat. § 55.19 regarding annual review of order authorizing involuntary administration of psychotropic medication.
- See Wis. Stat. § 55.23 regarding patients' rights.
- Wis. Stat. ch. 146 - Miscellaneous Health Provisions
- Wis. Stat. ch. 154 - Advance Directives
- Wis. Stat. ch. 155 - Power of Attorney for Health Care
- See Wis. Stat. § 155.20 regarding powers and limitations of a health care agent.
- Wis. Stat. ch. 244 - Uniform Power of Attorney for Finances and Property
- Wis. Admin Code ch. DHS 92 - Confidentiality of Treatment Records
- Wis. Admin Code ch. DHS 94 - Patient Rights and Resolution of Patient Grievances
- Wis. Admin Code ch. DHS 107 - Covered Services
- Wis. Admin Code ch. DHS 129 - Certification of Programs for Training and Testing Nurse Aides, Medication Aides and Feeding Assistants (Appendix A)
- Wis. Admin Code ch. DHS 132 - Nursing Homes (Appendix A)
- Wis. Admin Code ch. DHS 133 - Home Health Agencies
- Wis. Admin Code ch. DHS 134 - Facilities Serving People With Developmental Disabilities (Appendix A)
- Wis. Stat. ch. 46 - Social Services
2009 Wisconsin Act 281 (Wis. Stat. § 50.08): Informed consent is required before administration of psychotropic medication to a nursing home resident who has degenerative brain disorder
ForwardHealth Update 2008-43: Policy changes for PASRR Level 1 and nurse aide training/testing (PDF)
ForwardHealth Update 2009-42: Revised forms for nursing facilities (PDF)
Medicaid Handbook Topic #3189: Specialized Services
Nursing homes are also eligible for a $9.00 per member, per day supplement to the nursing home's daily rate for members with a serious mental illness who have been determined by the PASRR to require specialized services. Payments are made quarterly and are reflected on the nursing home's RA.
This supplemental reimbursement is available for members who are not developmentally disabled and only for those days on which the member is in the facility and receiving specialized services, so therapeutic and hospital bed hold days do not qualify. There is no supplement to the daily rate for the developmentally disabled members because of the funding sources for specialized services, including the Medicaid nursing home formula.
ForwardHealth Update 2017-04: New policy for nursing homes regarding developmentally disabled level of care assignments
- Finding and choosing facilities serving people with developmental disabilities
- Finding and choosing mental health care treatment programs
- Finding and choosing a nursing home
- Finding and choosing alcohol and other drug abuse treatment programs
Wyatt v. Stickney (U.S. District Court)
Olmstead v. L.C. (U.S. Supreme Court)