PASRR - Introduction

I.   Introduction

a. Explanatory Statement.  The Preadmission Screening and Resident Review (PASRR) program seeks to ensure that persons who are otherwise eligible for care in a nursing facility (NF) and who also have a mental illness or developmental disability receive the additional care necessary to meet their needs.  Persons whose needs for specialized services due to mental illness or developmental disability are too great for NFs to provide will be referred to a more appropriate level of care and service.  

The general eligibility for NF care is not a subject of this manual.  Persons may not be admitted to NFs due to mental health or developmental disability needs alone; persons must meet the general medical eligibility requirements for NF care prior to the administration of the Level I screen. 

Periodic PASRR reviews after admission, initial screening and assessment, will not result in changes in eligibility for NF care, unless the person’s needs are greater than an NF can provide.  Changes noted through PASRR reviews after admission may result in changes in the level or intensity of specialized services, including referral to a more intensive level of care outside the NF. 

The first edition of this manual was issued in 1997, to serve as a reference and guide to staff of nursing facilities and hospitals and other interested parties.  This edition of the manual has been revised to reflect some changes in the PASRR process.  The processes described here have been reviewed to ensure that there is full integration with other evaluative and care-planning processes.  Significant additions to the manual include an operational definition of “change in condition” for mental health and developmental disability and flow charts/diagrams of the PASRR review process.  

b. Authority.  Screening and evaluation through the PASRR program is required for participation in MaineCare.  Persons who do not comply with the requirements of the PASRR program may be denied payment for services provided in an NF.  Similarly, NFs that do not comply may have MaineCare billings disallowed.  The required elements of a PASRR program are described in detail at 42 CFR Ch IV, Subpart C (§483.100 et seq.). 

It is available for purchase from the Superintendent of Documents, PO Box 371954, Pittsburgh PA 15250-7954.  It is also available at many public libraries.

This manual is published under the authority of the Department of Health and Human Services (DHHS). DHHS is the state mental health and the state developmental disability authority.  This manual coincides with the requirements of the MaineCare Manual as described at 10-144 CMR Ch II, Section 67.05. 

For further information or technical assistance for the PASRR program, please contact Preadmission Screening Services for Adult Cognitive and Physical Disability Services in the DHHS Regional Office nearest you.  For Adult Mental Health Services please contact the statewide PASRR Coordinator in Region 2.You will find the addresses and phone numbers in the Directory section of this manual.  Users of this manual are encouraged to contact their Provider Relations Specialist in the DHHS Office of MaineCare Services for questions related to MaineCare, or the Office of Licensing and Regulatory Services for questions related to licensing requirements.