Level One Pre-Admission Screening and Resident - DSHS - WA - dshs wa 2026

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Definition and Meaning

The Level One Pre-Admission Screening and Resident Review (PASRR) is a federal requirement for individuals seeking admission to Medicaid-certified nursing facilities. This process identifies individuals who have serious mental illnesses or intellectual disabilities. The purpose of the screening is to ensure these individuals receive the necessary specialized services alongside their standard care in the nursing facility. Under this screening, no individual can be admitted to a nursing facility before the process is completed and assessed against federal and state guidelines.

How to Use the Level One Pre-Admission Screening and Resident Review

The Level One PASRR process requires administrators and healthcare professionals to carefully follow a structured assessment. Facilities must use the designated forms to evaluate whether a prospective resident has a serious mental illness or intellectual disability. If indicators for these conditions are evident, the screening will determine if a more thorough evaluation or specialized services are required. This involves accurately filling out the form, ensuring all sections are completed in accordance with state guidelines, and attending to any additional requirements specific to the individuals' diagnoses.

Steps to Complete the Level One Pre-Admission Screening and Resident Review

  1. Gather Necessary Information: Collect detailed medical histories, current mental health information, and prior treatments or diagnoses of the individual.
  2. Complete the Screening Form: Ensure all sections are filled out according to instructions provided by the Department of Social and Health Services (DSHS) in Washington State. Include details on the individual's mental health and any intellectual or developmental disabilities.
  3. Verify Information: Double-check the completed form for accuracy to avoid delays or errors, as incorrect information can lead to non-compliance with PASRR guidelines.
  4. Submit the Form: Send the completed form to the appropriate state agency for review. Submission can typically be done via mail or through specified electronic means.
  5. Follow-up: Await confirmation from the state agency and be prepared to provide additional documentation or attend meetings if further assessment is necessary.

Important Terms Related to Level One Pre-Admission Screening and Resident Review

  • PASRR: Pre-Admission Screening and Resident Review, a process to ensure appropriate placements for individuals with mental health needs or intellectual disabilities.
  • Specialized Services: Additional support required for individuals identified during the PASRR process, often involving tailored treatment plans or therapies.
  • Medicaid-Certified Nursing Facility: A healthcare facility that meets specific standards allowing it to receive Medicaid funding and admits individuals following the Medicaid guidelines.

Legal Use of the Level One Pre-Admission Screening and Resident Review

The legal framework governing the Level One PASRR process stems from federal requirements, ensuring individuals with mental illnesses or intellectual disabilities receive proper care and services. The process is part of the broader regulatory oversight exercised by the Department of Social and Health Services, aligning with federal mandates to protect the rights and health care needs of vulnerable populations. Compliance with PASRR is legally mandatory for all Medicaid-certified facilities.

State-Specific Rules for Washington State

In Washington State, the DSHS oversees the implementation of PASRR processes, dictating specific procedures and protocols. Facilities are required to adhere strictly to state-provided forms and instructions. Washington State may impose additional guidelines or conditional requirements tailored to its local governance and health care frameworks, such as unique documentation requests or collaboration with state agencies.

Penalties for Non-Compliance

Non-compliance with PASRR requirements can lead to significant penalties for nursing facilities. Consequences may include fines, loss of Medicaid certification, or other penal measures implemented by both state and federal authorities. Facilities must ensure strict adherence to PASRR guidelines to avoid these negative repercussions, thereby safeguarding both the institution's operational status and the welfare of its residents.

Key Elements of the Level One Pre-Admission Screening and Resident Review

  • Assessment Tools: Documents and forms designed to consistently evaluate mental health and intellectual capabilities.
  • Screening Process: A structured approach including data collection, form completion, and submission for state review.
  • Collaboration: Engagement with healthcare providers, social workers, and state agencies to ensure accurate assessments.
  • Follow-up Procedures: Steps taken after submission, including potential further evaluations or specialized care coordination.

Required Documents

Submission of the Level One PASRR requires several documents, including medical records, prior assessments, and any related documentation of mental or intellectual health. Having a comprehensive set of records can prevent delays in the evaluation process. Facilities must work closely with residents and their families to gather all necessary paperwork, ensuring compliance and readiness for submission to the relevant authorities.

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Access the PASRR Online System. Select the Log In button. Enter your email and password. A code will be sent to your cellphone. Enter the code and select Verify. Once logged on, select the PASRR icon. Please follow the instructions in the MS Azure Registration Manual for more information.
In the case of an RR, the NF initiates the process by submitting a Level I Screening as an RR in the PASRR system. A Level 1 Screening is used to identify if an individual has, or is suspected of having, a PASRR condition, i.e., SMI, ID/DD, or RC.
A Level 1 Screening involves completion of an evaluation to determine if an individual has, or is suspected of having, a PASRR condition, i.e., serious mental illness (SMI), intellectual disability (ID), developmental disability (DD), or related condition (RC).
After your surgery is scheduled, the next step is to complete an interview with Pre-admission Testing (PAT). PAT helps to ensure that you are in your best possible condition before surgery or a procedure. This can mean that you may need further evaluation or testing.
Skilled nursing facilities typically offer three levels of care - Level 1: Basic Care, Level 2: Skilled Care, and Level 3: Specialized Care. The appropriate level of care is determined based on the individuals care needs, medical conditions, and the level of assistance required for activities of daily living (ADLs).

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