Preadmission Screening and Resident Review (PASRR)

Level I screening process

Individuals are first screened by a referring party to determine if they:

• Have a known or suspected mental illness (MI/SMI), an intellectual disability, or related condition (DD/ID/RC).
• Are being admitted to the appropriate level of care.
• Need specialized services or less intensive services.

The "referring party" includes the admitting hospital, primary physician and/or nursing facility.

Washington PASRR is operated by two agencies:

• Health Care Authority (HCA): HCA operates the behavioral health (BH) portion of PASRR.
• Developmental Disabilities Association (DDA): DDA operates the DD/ID/RC portion or PASRR. 

For DD/ID/RC concerns and referrals, please visit the DDA site.

For more information, visit the DDA's PASRR individuals with intellectual disabilities and related conditions page.

When should Level I screening be completed?

Level I screenings should be completed as soon as nursing facility (NF) placement is considered.

• Hospital admission is the ideal time to identify potential PASRR clients as it allows for schedule coordination between the hospital and the PASRR evaluator.
• The BH PASRR evaluator will evaluate all (+) Level I PASRR Screens and provide a determination prior to SNF admission per WAC 388-97-1915.

What do I do once the Level I Screening form is completed?

If the Level I screening is positive for an known or suspected MI/SMI:

• Forward the (+) Level I and substantiating documents to the BH PASRR evaluator for your area.

If the Level I screening is positive for both MI/SMI and DD/ID/RC:

• Referrals must be sent to both the BH PASRR evaluator and your DDA regional contact.

View the PASRR level 1 flow chart for details.

Level II

HCA contracts and appoints BH PASRR evaluators. 

For each PASRR Level I that is positive for a known or suspected mental health issue (a.k.a. credible suspicion), a BH PASRR evaluator must decide whether a Level II evaluation or a Level II invalidation is appropriate.

To contact your local PASRR evaluator, view the contractor information map.

Per WAC 388-97-1915, a Washington skilled nursing facility can deny admission of patients with a Positive PASRR Level I until a Level II Evaluation/Invalidation has been completed.

PASRR training

Annual hospital and nursing facility PASRR webinar

The Washington PASRR Webinar is held in November of each year. View the presentation.

Recurrent State Training

HCA provides BH PASRR training on the last Tuesday of every month from 10 to 11:30 a.m. To sign up, please email Beth Loska or Tabitha Craven.

Register to attend the training.

PASRR 101 Training – PASRR Technical Assistance Center (PTAC)

Understanding federal requirements, purpose, importance and components of the PASRR process.

View the PASRR 101 Training.

Can I get training at my facility?

Yes. To request a training for your facility, please email Beth Loska or Tabitha Craven.

Who do I contact for help?

For all Washington MH PASRR Level II inquiries, first contact your regional contractor.

BH PASRR staff

Email: Beth Loska
BH PASRR/LTC transition coordination manager
Phone: 360-725-1478

Email: Tabitha Craven
BH PASRR program manager
Phone: 360-725-1107

For completed PASRR Level II documentation

To request a copy of the Washington BH PASRR Level II evaluation/invalidation be emailed to your facility please email your regional PASRR contractor and/or HCA PASRR staff with the following information:

• Individuals full name
• Date of birth
• Your name
• Your facility
• City and county your facility is located

All completed PASRRs for Washington are electronic and emailed from the Washington Integrated System for PASRR (WISP). All reports will be emailed from svcgraphwisphca@hca.wa.gov. 

To update the email address for your facility in WISP, please contact your regional PASRR contractor and/or HCA PASRR staff.