Pre-Admission Screening and Resident Review (PASRR)

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Information & Resources
for Referring Entities

Hospitals & Physicians

Preadmission Screening and Resident Review (PASRR) is a federal requirement to help ensure that individuals are not inappropriately placed in nursing homes for long term care. PASRR requires that 1) all applicants to a Medicaid-certified nursing facility be evaluated for mental illness and/or intellectual/developmental disability; 2) be offered the most appropriate setting for their needs (in the community, a nursing facility, or acute care settings); and 3) receive the services they need in those settings. 

In brief, the PASRR process requires that all applicants, prior to admission to a Medicaid-certified Nursing Facilities be given a preliminary assessment to determine whether they might have mental illness (MI) or an intellectual or developmental disability (IDD). This is called a “PASRR Level I screen” or "PL-1" Those individuals who test positive on the PL-1 are then evaluated in depth, called “Level II” PASRR Evaluation or "PE". The results of this evaluation result in a determination of need, determination of appropriate setting, and a set of recommendations for services to inform the individual’s plan of care. Forms »

Who or what is considered a Referring Entity?

Hospitals, Doctors' Offices, Law Enforcement, Home Health Agencies, and Hospice Agencies are all considered Referring Entities.


PASRR in Texas

The Texas program is currently undergoing a redesign in response to direction from the Federal Centers for Medicare and Medicaid Services (CMS). The Texas Heatlh and Human Services Commission (HHSC) formed an interagency workgroup to examine the concerns with the Texas program as identified by the CMS. More information on the PASRR Redesign project is available at

Additional Information and Resources

Department of Aging and Disability (DADS) PASRR Redesign

  • Family members, consumers, and providers can access background information and tools related to PASRR at

Federal and State Regulations

For Referring Entities Responsible for PASRR Referrals - Hospitals & Physicians’ Offices

Last updated August 16, 2013