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
Are you looking for the PASRR Level I screening 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 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).
Level II
The Health Care Authority (HCA) contracts and appoints Behavioral Health PASRR evaluators to complete the Level II determination.
For each Level I that is positive for a known or suspect mental health issue, a PASRR MH Evaluator must decide whether a Level II evaluation assessment or a Level II invalidation should be completed.
For contact information for the local PASRR Evaluator in your area, view the contractor information map.
PASRR training
2024 annual hospital and nursing facility PASRR webinars
The 2024 Washington PASRR Webinar was held on November 19 and 20. View the presentation.
Information for hospitals, medical offices, and nursing facilities
HCA provides behavioral health specific training on the last Tuesday of every month from 10 to 11:30 a.m. To attend, email Beth Loska or Tabitha Craven.
Level I best practices
Best practice guidance for PASRR evaluators when completing a Level I screening.
Can I get training at my facility?
Yes! To request a training in your Washington State facility or community:
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
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