​​​​​​​​​​​​​​​I have questions about the Level I Screening

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When to Submit a Level I Screening

The individual temporarily left the facility. Do I need to do a new PASRR?

If an initial preadmission screening (PAS) Level I was already submitted for the individual and there is now a significant change in the individual's physical or mental condition, then you will need to submit a new PASRR Level I screen as a Resident Review (RR). ​

If the individual is admitted on the weekend and no one is available to complete the Level I, will we be penalized when completing the PASRR during the week?

​​Yes. You may lose reimbursement for the late days from the individual's admission date to the date you initiated the Level I Screening. ​​​

If the Nursing Facility to which the individual is being admitted to is not a Medicaid facility and serves only Private Pay individuals, is the General Acute Care Hospital required to submit a Preadmission Screening? Will the Nursing Facility be required to submit a Resident Review?

​​No. Complete the Level I Screening only if the individual is being admitted to a Medicaid NF or is currently  residing in a Medicaid NF.

If the individual does not have a mental illness or intellectual disability, do I still need to complete the PASRR process?

​Yes, a Level I Screening is required at the time of admission to a Medicaid NF, or if there is a significant change in condition. However, submission does not guarantee a Level II evaluation. 

When does a Medicaid NF submit a Level I Screening?

An initial Preadmission Screening (PAS) Level I should be completed for all new admissions to the Medicaid NF. A Resident Review (RR) Level I Screening must be submitted when there is a significant change in the individual's physical or mental condition. 

I work at a Medicaid NF. An individual was admitted to our facility from a General Acute Care Hospital. A preadmission Level I Screening (PAS) was completed, but it indicated that the individual's stay at this facility will be less than 30 days. After admission, it has been determined that the individual will be staying here for more than 30 days. Do I have to submit a new Level I Screening? When do I submit it?

​You will need to submit a new Resident Review (RR) Level I Screening if the individual's stay will now exceed 30-days. The Level I Screening must be completed by the 40th calendar day from the date of admission.

​Do I submit the Level I Screening if the individual is expected to stay less than 30 days at the nursing facility?

​Yes, you will complete and submit the Level I Screening. Select “Yes" when answering the 30-Day Exempted Hospital question on the Level I Screening.  All conditions must apply to meet the 30-Day Exempted Hospital:

1. The individual is directly admitted to the Medicaid nursing facility from a hospital after receiving acute inpatient care and;
2. The individual requires nursing facility services for the same condition the individual was receiving care for in the hospital and;
3. The attending physician has certified prior to nursing facility admission that the individual's stay is likely to require less than 30 days at the Medicaid nursing facility. 

However, you must submit a Resident Review (RR) Level I Screening by the 40^th calendar after admission if the individual's stay exceeds 30 days.

​Do I submit a new Level I Screening if an individual is returning from a post-bed hold (has been re-admitted)?

If you have already submitted an Initial Preadmission Screening (PAS) Level I Screening, and there is no significant change in condition, a new Resident Review (RR) Level I Screening is not required.

​A new Level I Screening would be required in the following situation:

An individual leaves your facility to receive acute care from a hospital for a medical or mental health condition. Upon returning to your facility, a new Level I Screening (RR) is required if there is a significant change in the individual's condition. A significant change of condition is any change (mental or physical) that can impact treatment.

​Completing the Level I Screening screen

Who can complete the Level I Screening?

​​​​It is the facility's responsibility to designate qualified staff that can complete the Level I Screening.

​What is a PASRR CID number?

​The PASRR CID number is a nine-digit PASRR identification number. This number is automatically assigned by the Online system for each PASRR. Please use the PASRR CID number when contacting DHCS about a specific case. This will help prevent violation of HIPAA regulations.​ 

Does a MD need to sign the Level I Screening?

​No, a physician's signature is not required on the Level I Screening.

If the individual does not trigger positive for MI/ID on admission, but does in the MDS, should the facility submit another PASRR?

​Yes. This submission would be a Resident Review (RR) Level I.

​If a Level I Screening is done upon admission and records do not state any mental disorder, but days after admission information is  provided stating individual does have a mental disorder, do we do another Level I Screening?

​Yes, this would be submitted as a Resident Review (RR) Level I because of a significant change in condition. You must do a Resident Review for any significant change of condition, including significant disruption. 

What if an individual has a dual diagnoses of Mental Illness (MI) and Intellectual Developmental Disorder (ID)?

​The California Department of Developmental Services (DDS) oversees the PASRR process for individuals identified with ID/DD/RC. The Department of Health Care Services (DHCS) oversees the PASRR process for individuals identified with MI. Once the Level I Screening is submitted online, it will automatically be referred to the DHCS Level II Contractor for further evaluation. The facility is not required to print the pdf Level I Screening and mail or fax it to DHCS.   DHCS has access to all Level I cases in the Online PASRR system.

If you need to contact DDS directly:

​DDS Phone: 916-654-1954 
DDS Fax: (916) 654-3256

​Changing Information on a Level I Screening.

I made a mistake on the Level I Screening. How do I fix this?

​Data on the Level I Screening cannot be edited once the screening has been submitted online. Please contact (800) 579-0874 ​select option 2​ or email an inquiry to ITServiceDesk@dhcs.ca.gov for further assistance. The DHCS IT Service Desk hours are Monday-Friday 7:30am-5:30pm. It is closed on weekends and state holidays. 

Can I delete a Level I Screening?

​The Level I Screening cannot be deleted once it has been submitted. Once you start a Level I Screening and the system assigns it a CID number, the Level I will remain “In-Progress" for two weeks until it is submitted. If the Level I is not submitted within two weeks, the system will delete the Level I. 

​Can I change the start date on the Level I Screening?

​​No. The start date is automatically assigned by the Online PASRR system. This field cannot be changed manually.

​Change in Condition

What is a significant change of condition?

​There is no federal guideline specific to PASRR that defines “significant change in condition." CMS recommends that you refer to the latest version of the MDS  to make a decision on whether the individual has had a “significant change in condition." According to the MDS manual, a “significant change" is a decline or improvement in an individual's status that:

• Will not normally resolve itself without intervention by staff or by implementing standard disease-related clinical interventions, is not “self-limiting" (for declines only);
• Impacts more than one area of the individual's health status; and
• Requires interdisciplinary review and/or revision of the care plan.