PASRR FAQ: I need information about the PASRR program
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General Information about PASRR
1. What is PASRR?
The Preadmission Screening and Resident Review (PASRR) is a federal program implemented in 1987 to:
- Prevent individuals with mental illness (MI), intellectual disability (ID) or related conditions (RC) from being inappropriately placed in a Medicaid certified nursing facility (NF) for long-term care.
- Ensure NF individuals with MI, ID or RC receive specialized services and
- Ensure individuals have the opportunity to live in the least restrictive setting that best meets their needs.
2. Where can I find regulations regarding PASRR?
You can access the
Code of Federal Regulations (CFR) 483.100 – 483.138 for information on regulations.
3. What is the difference between an “Initial Preadmission Screening" and "Resident Review"?
You must make a selection of either an “Initial Preadmission Screening" (PAS) or a “Resident Review" (RR) when completing the Level I Screening. Select PAS for all individuals newly seeking Medicaid NF care. Select RR if there is a significant change in the individual's mental or physical condition.
4. Do I need to do a PASRR every year?
The Balanced Budget act of 1996 eliminated the requirement for an Annual Resident Review, specifying that Resident Reviews (RRs) are required instead, based upon significant changes in condition.
5.
Do I need to do a PASRR for existing long-term individuals?
You must submit a new Resident Review (RR) Level I Screening when there is a significant change in an individual's condition.
6. What is a County Mental Health Plan?
Specialty mental health services are authorized for Medi-Cal beneficiaries through County Medi-Cal Mental Health Plans (MHPs). The MHP can provide services through its own employees, or through contract providers.
Individuals can review Medi-Cal specialty mental health services, if they are Medi-Cal beneficiaries, if the service is both a covered service under the Medi-Cal program, and is medically necessary. The complete description of these covered services can be found in the
Medi-Cal regulations at Title 9, California Code of Regulations (CCR) beginning with section 1810.100.
7. Is a PASRR required for Swing Beds?
PASRR does not apply to swing beds. Swing bed information
“The Social Security Act (the Act) permits certain small, rural hospitals to enter into a swing bed agreement, under which the hospital can use its beds, as needed, to provide either acute or SNF care. As defined in the regulations, a swing bed hospital is a hospital or critical access hospital (CAH) participating in Medicare that has CMS approval to provide post-hospital SNF care and meets certain requirements. If the individual transitions to a Medicaid NF (i.e., not a swing bed), then PASRR would apply, and the individual may require a Level II evaluation.
Remember: Whether PASRR applies has nothing at all to do with the individual's insurance type. It depends entirely on the certification of the facility (and, in this case, whether we are talking about a swing bed).
Contact Us
1. How can I contact PASRR?
You may call the DHCS IT Service Desk at (800) 579-0874 select option 2 regarding enrollment, PASRR system, PASRR program and policy questions. You may also direct your inquiries via e-mail to:
ITServiceDesk@dhcs.ca.gov. The DHCS IT Service Desk hours are Monday-Friday 7:30am-5:30pm. It is closed on weekends and state holidays.
If calling, please leave a detailed message that includes your name, email address, your facility name, phone number, the PASRR Case Identification (CID) number, if applicable, and other details on the nature of your call.
2. Where can I find more information and training opportunities?
Please visit the
PASRR website routinely for updated information and
PASRR training opportunities.
