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Pre-Admission Screening and Resident Reviews

What are they and why are they required?

Pre-Admission Screening and Resident Review (PASRR) is a powerful and effective program established by the Centers for Medicare and Medicaid Services (CMS) to ensure that persons with serious mental illness, intellectual, and/or developmental disabilities are placed in the least restrictive setting and receive recommended interventions to improve their quality of life. More recently, the PASRR program has emerged as one of the key methods and most effective tools for identifying persons with these conditions and providing the needed care and services.

PASRR has a wide-ranging statewide and national impact, affecting hospitals, nursing facilities, other providers, caregivers, and family members.  PASRR assessment outcomes can influence numerous other long-term care services, including Waiver programs, IMD monitoring, housing, funding, and other essential services and initiatives.

CMS PASRR Requirements

State requirements for PASRR are set forth in the 1992 PASRR Final Rules published in Vol 57 No. 230 of the Federal Register and codified in the Code of Federal Regulations (C.F.R.) at; 42 C.F.R. § 483, Subpart C. The Rule outlines requirements and provides an in-depth explanation of the purpose for PASRR and its required approach. Though the original rule has not been updated, a 1996 law (Public Law (PL) 104-315) repealed PASRR Annual Resident Reviews, substituting them with a requirement that a new evaluation be conducted whenever a nursing home resident with a mental health or developmental/intellectual disability experiences a significant change in status. “Significant change in status” is defined in the Minimum Data Set Guidelines (Chapter 2). Long-term care regulations require that nursing facilities, in partnership with state mental health and developmental disability state authorities, deliver or ensure delivery of all services and supports defined in each PASRR evaluation. These requirements were strengthened under the revised nursing home reform regulations, which became effective November 28, 2016.

PASRR requirements are complex. That complexity has grown in recent years due to pressure by key stakeholders. Key concerns include: hospital demands for faster turnaround, CMS demands for fully effective Level I systems, broadened specialized services, and person-centered evaluations, which identify a full range of services and supports. Another concern focuses on the imperative for close alignment with nursing home providers to educate – both about PASRR requirements and about their residents with disabilities. We fully understand these complexities. Through Maximus U.S. Services we manage all aspects of PASRR and provide expert consulting services that meet your state’s unique needs and specific requirements.