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Virginia Health Care Association | Virginia Center for Assisted Living

Critical Info on PASRR/Level I Screenings

Critical Info on PASRR/Level I Screenings

In a Medicaid Memo on the Preadmission Screening and Resident Review (PASRR) Process issued November 19, the Department of Medical Assistance Services (DMAS) has established a process that can be facilitated by appropriate nursing facility (NF) staff so required Level I screenings can be completed between now and July 1, 2019. The process also allows, as of November 19, 2018, for appropriate NF staff to conduct the Level I screenings for all new non-Medicaid eligible applicants. 

Level I Screenings Are Required Prior to Admission to a NF

By federal law, an individual shall not be admitted to a Medicaid-certified NF unless a Level I screening has been completed, and, if it is determined that the individual has a Serious Mental Illness (SMI), Intellectual Disability (ID), and/or a Related Condition (RC), then the individual shall not be admitted until the Level II evaluation and determination has been completed. 

Survey and Reimbursement Implications

Beginning in November 2017, surveyors were required to document evidence of Level I screenings for NF residents as a part of the federal certification and state survey process.

Surveyors have documented that some NFs admitted individuals without a Level I screening. To address the concern, DMAS and the Virginia Department of Health (VDH) have been working together, with significant input from VHCA-VCAL, to assure that NF residents who have not had these mandated Level I screenings have them completed as quickly as possible.

Also, please note that per federal regulations, failure to complete the PASRR process prior to admission process will result in forfeiture of Medicaid reimbursement during the period of non-compliance.

Transition Period to Complete Level I Screenings

As described in the Medicaid Memo, from November 19, 2018 through July 1, 2019, NF staff who have medical knowledge of the resident and knowledge of the medical terminology in the Level I screening may temporarily complete these screenings for all residents in a NF who do not have a Level I screening. Any individual identified as needing a Level II evaluation and determination must be referred to the Level II evaluator, Ascend, A Maximus Company, as outlined in the memo.

Surveyors will continue to issue deficiencies for individuals in a NF who have not had a Level I screening. However, the expectation is that because you can use the appropriate staff in your facility to complete these screenings, the process of completing the screenings for all residents should move more quickly. By July 1, 2019, all residents in a NF who did not have a Level I screening should have one completed.

Screening Forms  

Nursing facilities may use the DMAS-95 Level I SMI, ID, or RC form provided on the DMAS website.  Follow these directions to download the form:

  1. Go to the DMAS Provider Forms Search webpage:
  2. Select the following options from the drop-down menu:

Type: Pre-Admission Screening
Category: Pre-Admission Screening

The Medicaid Memo provides other important details about role of screening teams, and screening for non-Medicaid eligible and newly-eligible applicants.

If you have any questions or need any additional information about the PASSR/Level I Screening process, contact April Payne.