FAQs

Originally, Resident Reviews—Level II post-admission evaluations—had to be conducted annually; hence, the original name of the program was Preadmission Screening and Annual Resident Review, or PASARR, which is the title that is still in the rule.

The Code of Federal Regulations (CFR) is clear at §483.102 that PASRR is required for all individuals who apply to or reside in a Medicaid-licensed nursing facility (NF), regardless of insurance type (Medicaid, Medicare, or private pay). Thus, private pay applicants who test positive at Level I could be found at Level II to need specialized services. By definition, however, all services supplied to individuals who have private insurance are not covered by the state. This includes specialized services, whatever those are determined to be.

The CFR does not specify how quickly Level I's must be completed, and with good reason: There is no baseline against which to establish timing requirements.

While MDS captures information about a person (medical, functional, cognitive, and social) at a moment in time, it does not evaluate individuals for the presence of disabilities defined for the purposes of PASRR.

In order to be eligible for federal financial participation (FFP), Specialized Services must be included in the State Plan. They are considered “specialized add-on services” that can be provided under the nursing facility benefit authorized the Section 1905(a) of the Social Security Act.

According to §1903(a)(2)(C) of the Social Security Act and 42 CFR 433.15(b)(9), activities that can be clearly tied to the administration of PASRR, and in accordance with an approved cost allocation plan, may be claimed at the enhanced 75% match.

No, a nursing facility cannot perform a Level II pre-admission evaluation or resident review. 42 CFR §483.106(e)(iii) prohibits nursing facilities (or any entity that has a direct or indirect affiliation or relationship with a nursing facility) from performing Level II evaluations. Because nursing facilities are responsible for providing nursing services, it is considered a conflict of interest for them to determine the individual’s service needs. Additionally, while nursing facilities are not prohibited from performing Level I screens, both Level I screens and Level II evaluations must be completed prior to admission.

Federal regulations give states the authority to claim FFP for administrative activates associated with the PASRR program included in their State Plan at Part §433.15(a)(9) of the CFR. Eligible (PASRR) activities conducted by the State may be claimed at 75%.

To understand what PASRR activities cannot be claimed at the 75% Federal Financial Participation (FFP) match, one must first be clear on what activities are eligible for FFP.