Preadmission screening and resident review (PASRR)

Preadmission Screening and Resident Review (PASRR) is a federally required screening of all individuals who are being referred to Medicaid-certified nursing facilities (NF). As a condition of approval of the Medicaid state plan, each state is required operate a PASRR program.

The Washington State PASRR process includes two levels.

Are you looking for the PASRR Level I Screening form?

Download the Level I form

Level I

Individuals are first screened to determine if they:

  • Have a serious mental illness, an intellectual disability, or related condition.
  • Are being admitted to the appropriate level of care.
  • Need specialized services, or less intensive services.

Who completes the Level I?

Level I is completed by the referring party, usually the referring hospital or physician.

Where can I get the Level I form?

You can download the form on our website:

Hands of a nurse guiding the hands of an older person reach for a cane

When should the Level I be completed?

The Level I should be completed as soon as NF placement is considered

Indicators of SMI or ID/RC require follow up by the mental health (MH) PASRR evaluator or the ID/RC PASRR evaluator prior to NF admission.

What do I do once completed?

Note: Additionally, a copy of the completed Level I must be sent to the receiving nursing facility (NF).

Level II

Map of Washington showing the pasrr regions and evaluator contact information

The Health Care Authority (HCA) contracts with PASRR evaluators to complete the Level II process. Evaluators must pass a background check and meet education and training requirements before they can perform Level II assessments.

For each Level I that is positive for MH, a PASRR MH Evaluator must decide whether a Level II Evaluation assessment or a Level II Invalidation should be completed. 

To learn more and for contact information for the contractor in your area, download the Quick Reference Guide and Contractor Information map.

PASRR training

Learn how to be a PASRR Star

In this short video (6:36), Jennifer, one of our King County evaluators discusses the Level I and Level II from the Washington State Mental Health Division of PASRR.

Information for hospitals, medical offices, and nursing facilities

A comprehensive overview of PASRR, including what PASRR does, how it works, how to refer, and how to complete the PASRR Level I form.

Level I best practices

Best practice guidance for PASRR evaluators when completing a Level I screening.

Level II training for mental health evaluators

Large modern building with trees in the front and a blue sky

Explanation and instructions for mental health evaluators completing the Level II form.

Can I get training at my facility?

Yes! To request a training in your facility or community:

  • Contact the contractor in your region.


Maureen Craig
PASRR administrative assistant
Phone: 360-725-1107

PASRR program