The Preadmission Screening and Resident Review (PASRR) Process for Intellectual Disability

(ID), Developmental Disability (DD), and/or Serious Mental Illness (SMI) (A) Introduction. Pursuant to 42 U.S.C. 1396r(e)(7) et. seq. and 42 CFR 483.100 et. seq., each individual, regardless of payment source, seeking admission to a nursing facility must be screened before admission to a nursing facility to identify individuals who have or are suspected to have ID, DD, and/or SMI. (B) PASRR Level I Screening. (1) A Level I screening using the EOHHS PASRR Level I Screening form (Level I Screening Form) must be completed prior to admission for all individuals seeking admission to a nursing facility, regardless of payment source. (2) The Level I Screening Form must also be completed for resident reviews, upon a significant change in condition, and in any other circumstance required by EOHHS in sub- regulatory guidance. The completed Level I Screening Form must be submitted to the appropriate PASRR authority (DDS or its designee for ID or DD; DMH or its designee for SMI) and be kept in the resident’s medical record at the facility. (C) Referrals for PASRR Level II Evaluation and Resident Review. If the Level I screening indicates that the individual has or is suspected of having ID, DD, and/or SMI, the screener must make the applicable referral or referrals to the appropriate PASRR authority (DDS or its designee for ID or DD; DMH or its designee for SMI) to complete a Level II evaluation and determination in accordance with any applicable sub-regulatory guidance. (D) PASRR Level II Determination (1) Prior to admitting individuals requiring a Level II PASRR evaluation and determination, the nursing facility must receive documentation from the applicable PASRR authority determining that the individual is appropriate for admission to the nursing facility and stating whether or not the individual needs specialized services. The nursing facility must keep such documentation in the resident’s record at the facility. (2) A determination by the Massachusetts Department of Mental Health (or its designee) or the Department of Developmental Services (or its designee) that admission to the facility is not appropriate supersedes the authorization for services by MassHealth or its agent.