Screening safeguards nursing home resident rights

DRW updates
Zach Burr
DRW Staff Attorney

What is PASRR?

In order to ensure that residents of nursing facilities receive care appropriate to their individual needs, Medicaid certified nursing facilities are required to perform a specific screening process for each applicant.

This screening process, known as the Preadmission Screening and Resident Review (PASRR) was designed ensure that residents received appropriate services and were placed in the type of environment that would best meet the individual’s needs.

PASRR was created in 1987 through language in the Omnibus Budget Reconciliation Act (OBRA). It has three goals: 1) to identify individuals with mental illness and/or cognitive impairment; 2) to ensure they are placed appropriately, whether in the community or in a nursing facility; and 3) to ensure that they receive the services they require for their mental illness or cognitive impairment.

PASRR was created to address concern voiced by the Office of the Inspector General, that large numbers of previously ‘de-institutionalized’ people had, instead, been ‘trans-institutionalized’ to nursing homes.

A PASRR screen involves two separate levels of evaluation. The Level I screen, given to all nursing facility applicants, aims to determine whether there is a possibility that that the applicant has a mental illness or cognitive impairment.   If such a possibility exists, then the individual is recommended for a Level II screen.  The Level II evaluation aims to delve deeper in to the diagnosis and to determine whether placement at a nursing facility is appropriate.  In addition, it enumerates the services the individual needs.

PASRR plays an important role in promoting care in the community in order to avoid institutionalization.  The Supreme Court decision, Olmstead vs. L.C. (1999) requires that all individuals have the right to live in the “least restrictive setting” possible.  By performing a thorough, individualized PASRR screen, health care providers can gain an increased understanding of the medical needs of the applicant, as well as their psychological, social, and functional needs.

If you or someone you know is applying to live in a nursing facility and you have questions about the PASRR process, contact a resource advocate at Disability Rights Washington.

More information about PASRR is also available at

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