Reports

This paper was produced to provide technical assistance to CMS and Preadmission Screening
and Resident Review (PASRR) state authorities (Single State Medicaid Agencies, state
Intellectual Disability/Developmental Disability authorities (SIDA) and state mental health
authorities (SMHA)) in considering the role that PASRR programs can play within managed care plans delivery systems.

The enclosed 2019 report (below) is the 8th State Preadmission Screening and Resident Review (PASRR) Policies and Procedures PTAC has produced. The report was prepared by the PASRR Technical Assistance Center (PTAC), a partnership between IBM Watson Health and Mission Analytics Group, under contract to CMS. This report also includes two new analyses. The first examines the prevalence of problematic behavioral symptoms among PASRR-identified individuals compared with NF residents who have not been
PASRR-identified. The second details the prevalence of dementia among individuals with an SMI. People with primary dementia and secondary SMI are statutorily excluded from PASRR identification (Section 1919(e)(7)(G)(i).

This paper builds on the Coverage Learning Collaborative guidance from the Centers for Medicare & Medicaid Services (CMS) on how states can support Medicaid operations and enrollees in times of emergency but focuses on options for addressing Preadmission Screening and Resident Review (PASRR) requirements. The purpose of this paper is to clarify the range of options that states have for addressing PASRR responsibilities, including those that do not require waiving PASRR requirements as part of an 1135 waiver. PASRR scenarios have been included to address common questions raised by nursing facilities (NFs) in past emergencies. This paper supersedes prior Center for Clinical Standards and Quality All-Hazards guidance.

The enclosed 2018 report (below) is the 7th State Preadmission Screening and Resident Review (PASRR) Policies and Procedures PTAC has produced. The report was prepared by the PASRR Technical Assistance Center (PTAC), a partnership between IBM Watson Health and Mission Analytics Group, under contract to CMS. The results present a snapshot of PASRR programs as of September 2018, with a focus on state PASRR expenditures and on our analysis of PASRR program elements that might influence state expenditures.

Preadmission Screening and Resident Review (PASRR) requires states to employ or contract with behavioral health care professionals to conduct assessments across a state, which may include assessments for individuals in remote locations, and requirements for assessments to be done within a relatively short time frame. In addition, the growing shortage of skilled behavioral health care professionals needed to conduct assessments may magnify barriers to PASRR compliance. Many of the barriers that people face when seeking in-person health care—including time, transportation, affordability issues and access to the appropriate health care provider—can be mitigated by using telehealth. The use of telehealth in PASRR is explored in a white paper recently completed by CMS’s PASRR Contractor. A few highlights of what the paper covers include: the definition of telehealth compared to telemedicine; modalities for telehealth; federal policies governing telehealth; and suggested applications of telehealth for PASRR. This new resource for state PASRR programs is now available here or at the bottom of this page.

The enclosed 2017 report (below) updates the 2016 Review of State Preadmission Screening and Resident Review (PASRR) Policies and Procedures. The report was prepared by the PASRR Technical Assistance Center (PTAC), under contract to CMS. The results present a snapshot of PASRR programs as of September 2017, with focus on our analysis of MDS data, and on our analysis of data that states collect for quality monitoring and quality improvement (QM/QI).

These issue paper provides written PTAC guidance to states on how to pay or arrange for Specialized Services, specifically for individuals with serious mental illness.

The enclosed 2016 report (below) updates the 2015 Review of State Preadmission Screening and Resident Review (PASRR) Policies and Procedures. The report was prepared by the PASRR Technical Assistance Center (PTAC), under contract to CMS. The results of this review presents a snapshot of PASRR programs as of September 2016, with focus on our analysis of MDS data, and on our (new) analysis of data that states collect for quality monitoring and quality improvement (QM/QI).

The enclosed 2015 report (below) updates the 2014 Review of State Preadmission Screening and Resident Review (PASRR) Policies and Procedures. The report was prepared by the PASRR Technical Assistance Center (PTAC), under contract to CMS. The results of this review presents a snapshot of PASRR programs as of September 2015, with a primary focus on the comprehensiveness of Level I tools and an analysis of Minimum Data Set (MDS) data. The survey does not capture any aspects of program implementation or performance.