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Preadmission Screening and Resident Review (PASRR)

The Preadmission Screening and Resident Review (PASRR) process is a requirement in all Indiana Health Coverage Programs (IHCP)-certified nursing facilities (NFs). All residents and prospective residents of an IHCP-certified NF are subject to the PASRR process, regardless of known diagnoses or methods of payment (Medicaid or non-Medicaid). Screening occurs prior to admission and when there is a significant change in the physical or mental condition of a resident (resident review or RR).

Screening Levels

All applicants to Medicaid-certified NFs in Indiana are entered in the state's web-based PASRR system, and a Level I screen is completed to initiate the PASRR process. When indicated, a Level II evaluation is then performed to identify the specialized needs of individuals with mental illness (MI), intellectual or developmental disability ID/DD, or both (MI/ID/DD).

Individuals seeking Medicaid coverage of their NF stay, as well as all individuals for whom a Level II assessment is triggered and certain other populations, must also undergo a level-of-care (LOC) assessment to determine whether they meet the necessary LOC criteria outlined in Indiana Administrative Code 405 IAC 1-3-1 or 405 IAC 1-3-2. Prior to any denial, individuals who do not appear to meet NF criteria receive an onsite assessment from an Area Agency on Aging (AAA) for a final determination.

More Information

For more information about PASRR, see the Long-Term Care provider reference module.

Resources pertaining to the PASRR process are also available on the Indiana Division of Aging Preadmission Screening Resident Review webpage and the Maximus Indiana PASRR Tools and Resources webpage.

Questions or issues regarding PASRR may be sent to

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