Florida pasrr form 2026

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  1. Click 'Get Form' to open the Florida PASRR form in the editor.
  2. Begin by filling out the Level I PASRR Screen (AHCA 004, Part A). Ensure all required fields are completed accurately.
  3. Next, complete the Request for Level II PASRR Evaluation and Determination (AHCA 004, Part B). This section requires detailed information about the individual’s mental health history.
  4. Include any relevant case notes or records of treatment that support the evaluation. This documentation is crucial for a comprehensive review.
  5. Attach the Medical Certification for Nursing Facility/Home and Community-Based Services Form (AHCA MEDSERV-3008) if applicable.
  6. Review all entries for completeness and accuracy before submitting. Use our platform's features to check for missing information.
  7. Once everything is filled out correctly, submit the form through our platform. You will receive confirmation of submission via email.

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The full PASRR process should always be completed prior to admission. Appropriately credentialed nursing facility staff can complete the screening anywhere, including at a hospice home, an assisted living facility, or even a home setting.
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.
The Pre-Admission Screening and Resident Review (PASRR) is a federally required screening of any individual who applies to or resides in a Medicaid-certified nursing facility, regardless of the source of payment.
To fill out the PASRR Level I Screen, start by providing the demographic information of the individual. Next, answer the mental illness screening questions based on the individuals history. Finally, ensure that all sections are completed accurately before submission.
Medicaid has strict financial eligibility requirements. Florida Department of Children and Families determines nursing home Medicaid eligibility for benefits. In Florida, your countable assets must be below $2,000 for a single person. Certain items are exempt, like your home and car.

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The PASRR Level I Screening is a preliminary assessment completed for all individuals prior to admission to a Medicaid-certified Nursing Facility in order to determine whether an individual might have a mental illness or intellectual disability.
A Level 2 Evaluation is a person-centered evaluation that is completed for anyone identified by the Level 1 Screening as having, or suspected of having, a PASRR condition, i.e., serious mental illness (SMI), intellectual disability (ID), developmental disability (DD), or related condition (RC).

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