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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 to operate a PASRR program. The Washington State PASRR process includes two levels.
On this page
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 Level I?
Level I is completed by the referring party, usually the referring hospital or physician.
When should Level I be completed?
Level I should be completed as soon as nursing facility (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?
- If the Level I screening is positive for a ID/RC:
- Forward the completed Level I to DDA.
For more information, visit the Department of Social and Health Services' (DSHS) PASRR individuals with intellectual disabilities and related conditions page.
- Forward the completed Level I to DDA.
- If the Level I screening is positive for an SMI:
- Forward the completed Level I to the contractor in your area. Download the contractor contact information map.
- If the Level I screening is positive for both SMI and ID/RC:
- Two referrals must be sent.
Note: Additionally, a copy of the completed Level I must be sent to the receiving nursing facility (NF).
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, view the contractor information map.
Information for hospitals, medical offices, and nursing facilities
Comprehensive overviews of PASRR, focusing on different topics each year.
- November 2021
- WA PASRR served by two agencies
- COVID-related timelines update
- What the 1135 Waiver means to PASRR
- Behavioral Health Support team
- Significant Change of Condition
- Resident Centered Care Planning
- BH PASRR Scenarios
- November 2020
- COVID-related PASRR timelines
- A timely new resource: behavioral health support team
- Referrals for significant change of condition
- November 2019
- In-depth view of PASRR Level I screening
- Person-centered care
Level I best practices
Best practice guidance for PASRR evaluators when completing a Level I screening.
Yes! To request a training in your Washington State facility or community:
- Contact the contractor in your region.
For all Washington MH PASRR Level II inquiries
Contact the contractor in your region first. View the contractor information map for phone and fax numbers.
Elizabeth (Beth) Loska
BH PASRR program manager
For Medicaid certified nursing facilities
If you need a copy of the Washington PASRR MH Level II assessment that was completed on an individual who is or was in your facility, contact the contractor for your region first. Contractors may direct you to:
The following information will be needed on each inquiry:
- Individuals full name
- Date of birth
- Your name
- Your facility
- City and county your facility is located
- If located out of the state of Washington, please include full address and attach the completed Level I
- Do you have a Notice of Determination for that individual? If yes, date of NOD
- Do you have the PASRR Level I? If yes, date of Level I