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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 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, view the contractor information map.

PASRR training

Information for hospitals, medical offices, and nursing facilities

Comprehensive overviews of PASRR, focusing on different topics each year.

  • 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
  • November 2018
    • What referring parties need to know
    • A look at power of attorney and how it relates to PASRR
    • Specialized services

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 Washington State facility or community:

  • Contact the contractor in your region.

Who do I contact for help?

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
Phone: 360-725-1478

Maureen Craig
Medical assistance program specialist 1
Phone: 360-725-1107

PASRR program
Fax: 360-507-9230

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:

Maureen Craig
Medical assistance program specialist 1
Email: Maureen.Craig@hca.wa.gov
Phone: 360-725-1107

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