Pre-Admission Screening and Resident Review (PASRR)
The California Department of Health Care Services (DHCS), Mental Health Services Division, is responsible for ensuring that a healthcare professional from an acute facility or nursing facility completes a Level I PASRR Screening Document (DHCS 6170) for each individual upon admission to a nursing facility. The purpose of the Level I Screening Document is to identify an individual who has a mental illness, or was previously diagnosed with a mental illness, a developmental disability, or a related condition to determine if specialized services are needed during the stay in a nursing facility.
When the Level I Screening Document identifies an individual diagnosed with mental illness, the Level I is referred to DHCS for further review. When the Level I Screening Document identifies an individual with a developmental disability or related condition, the Level I is referred to the Department of Developmental Services (DDS) for futher review.
The Level I document is reviewed by DHCS and/or DDS PASRR staff to determine if a Level II psychosocial evaluation is required. A Level II evaluation is necessary to ensure that the individual is placed in a facility that can provide the level of care and specialized services needed. DHCS contracts for independent licensed clinical staff to conduct the Level II evalaution. DDS refers to the area Regional Center that covers the resident's location. For additional DDS information click here (DDS).
After the Level II evaluation is completed DHCS and/or DDS issues a Level II determination letter with treatment and placement recommendations. A recommendation for community placement is made when applicable.
The Level II determination letter is sent to the individual evaluated, the nursing home administrator, the treating physician, the County Mental Health Plan and the field office in charge of Long Term Care (LTC) Treament Authorization Requests (TARS). A copy of the final determination letter is sent directly to the Conservator (if one has been appointed by the court.)
A Reconsideration Form is provided with the Level II determination letter in case the indivdual, the facility or the Conservator (if appointed) disagrees with the treament or placement recommendations. When DHCS/PASRR receives the Reconsideration Form, a clinican reviews the original treament and placement recommendations and considers additional/new information provided on the Reconsideration Form. The clinican sends a letter to the individual who requested the reconsideration and may modify the recommendations (s) or recommend no changes to the original determination letter.
The Nursing Home Reform Act was passed as part of the Omnibus Budget Reconciliation Act of 1987 (OBRA-87), and amended by Public Law 100-203 and 101-508, creating the Preadmission Screening and Resident Review (PASRR) program.
The State Mental Health Authority, DHCS, is responsible for ensuring that an evaluation of an individual’s need for mental health services and placement in a nursing facility occurs when the individual has, or is suspected of having, a mental disability. DHCS contracts for independent psychosocial and psychiatric evaluations of persons admitted to nursing facilities.