Preadmission Screening and Resident Review (PASRR) | State Mental Health Authority (SMHA)

 

 

The Office of Behavioral Health acts as the State Mental Health Authority (SMHA) for the federally required Preadmission Screening and Resident Review (PASRR) program for individuals entering Medicaid Certified Nursing Facilities within Colorado, which is managed by the Colorado Department of Health Care Policy and Finance.

The SMHA is responsible for making the Mental Illness (MI) Specialized Services (SS) and Nursing Facility (NF) determinations, based upon an evaluation conducted by an independent entity. The SMHA makes timely determinations based on these independent Level II evaluations of NF applicants and residents. Determinations made by the SMHA are based upon the above evaluations and contain all required information including any MI needs that are to be addressed in the NF plan of care.

Although the SMHA does not perform the evaluation, it receives the evaluation report and as a practical matter, the report may be part of or attached to the determination notice produced by the SMHA. The SMHA notifies the State Medicaid Agency (SMA) of any NF residents with Serious Mental Illness (SMI) whom the SMHA becomes aware of that did not receive a Level II evaluation before admission, and any problems with PASRR that are the SMHA's responsibility to address.

PASRR determinations made by the SMHA cannot be countermanded by the SMA through the claims payment process or through other utilization control/review processes, or by the Colorado Department of Public Health and Environment (CDPHE), survey and certification agency, or by any receiving facility or other involved entities.

For more information about the Colorado PASRR program, please visit the website here.

What is PASRR

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 serious mental illness (SMI) and/or intellectual 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.

PASRR is an important tool for states to use in rebalancing services away from institutions and towards supporting people in their homes, and to comply with the Supreme Court decision, Olmstead vs L.C. (1999), under the Americans with Disabilities Act, individuals with disabilities cannot be required to be institutionalized to receive public benefits that could be furnished in community-based settings. PASRR can also advance person-centered care planning by assuring that psychological, psychiatric, and functional needs are considered along with personal goals and preferences in planning long term care.

In brief, the PASRR process requires that all applicants to Medicaid-certified Nursing Facilities be given a preliminary assessment to determine whether they might have SMI or (ID). This is called a "Level I screen." Those individuals who test positive at Level I are then evaluated in depth, called "Level II" PASRR. 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. Regulations governing PASRR are found in the Code of Federal Regulations, primarily at 42 CFR 483.100-138.

Training

The Office of Behavioral Health regularly offers trainings for those involved with the Preadmission Screening and Resident Review (PASRR) process. PASRR is a federal requirement to help ensure that individuals are not inappropriately placed in nursing facilities for long-term care. PASRR requires that all applicants to Medicaid-certified nursing facilities be evaluated for serious mental illness and intellectual and developmental disabilities.

The trainings, which are available for nursing facilities, hospital administrators, hospital case managers, Mental Health Center evaluators, health care workers, and anyone else involved in the PASRR process, go over the PASRR requirements as well as what is a trigger for further (Level 2) evaluation. These trainings also provide more information regarding the need for PASRR and what requirements hospitals, nursing facilities, and single entry points need to follow in order to maintain their compliance.

OBH has increased its ability to offer the trainings. Contact PASRR manager Chellie Voss at michelle.voss@state.co.us to schedule training.

PASRR Technical Assistance Center

The PASRR Technical Assistance Center helps states fulfill the goals of Preadmission Screening and Resident Review. Family members, consumers, and providers can access background information and tools related to PASRR at www.pasrrassist.org

Frequently Asked Questions

Question: I am looking for more information and training on how to submit PASRR documents, where can I find this?
Answer: Visit the Department of Health Care Policy & Financing's Pre-admission Screening and Resident Review Program webpage. Click on the training tab for instructions on how to establish a user account for the new PASRR vendor (Telligen), recordings from trainings conducted in Feb/March 2021 as well as resources from Telligen including a step-by-step screenshot guide for Level I submissions.

Question: I am trying to check on the status of a triggered PASRR Level II. Who can I get this information from?
Answer: Access Telligen’s Qualitrac portal and view the status of any review that you have created yourself or any reviews that you have been granted visibility on. If you need additional assistance checking the status of a review, you may call Telligen’s provider support helpdesk at 833.610.1052.

Question: Where can I get a copy of an old Notice of Determination (NOD) and/or Level II evaluation?
Answer: For any MI Level II evaluations and MI NODs issued prior to March 1, 2021, please contact Chellie Voss at michelle.voss@state.co.us. In your request for any archived PASRR mental illness documents please include the resident’s name, DOB and the approximate timeframe of the evaluation and/or NOD effective date.

**Any NODs or Level II evaluations completed since 3.1.2021 can be found in Telligen’s Qualitrac portal. If you have difficulty navigating the Qualitrac portal to access these documents you may contact Telligen provider support at 833-610-1052.

Contact

To inquire more about PASRR Mental Illness (MI) Specialized Services (SS) and Nursing Facility (NF) determinations, please contact:

Chellie Voss OBRA | PASRR Manager
Office of Behavioral Health
michelle.voss@state.co.us| 720.646.2881