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Preadmission Screening and Resident Review
Contact Information
100 Fair Oaks Lane 4W-C
Frankfort, KY 40621-0001
Phone: (502) 564-4527
TTY: (502) 564-5777
Fax: (502) 564-2284

PASRR Contact
Tammy Swartz
(502) 229-1291

The Omnibus Reconciliation Act of 1987 (OBRA) and P.L. 100-203, Section 4211(c)(7), and OBRA 1990 contain provisions with major implications for persons with mental illness or mental retardation who are applying to or residing in a nursing facility. The provisions were designed to eliminate the practice of inappropriately placing persons with mental illness, mental retardation and related conditions in Medicaid-certified nursing facilities.

This Act mandates the Department as the state mental health and mental retardation authority to establish preadmission screening and resident review (PASRR) for all persons applying for admission to or residing in a nursing facility. Through the PASRR evaluation, the Department determines whether (1) the person requires nursing facility level of care and, if so, (2) whether the person also requires specialized services (active treatment).

Specifically, the PASRR program must ensure that the following conditions are met.

  • As of January 1, 1989, no person may be admitted to a Medicaid-certified nursing facility without first being screened for mental illness and mental retardation. This provision applies to the source of nursing facility placement.
  • As a result of this preadmission screening, referred to as the Level I, persons who appear to have a mental illness, mental retardation or related condition will undergo a comprehensive evaluation, referred to as the Level II, to determine the need for nursing facility placement and specialized services.

Note that on October 19, 1996, the President signed into law P.L. 104-315, which amends Title XIX of the Social Security Act to repeal the requirement for an annual resident review. The amendment requires nursing facilities to notify the state mental health or mental retardation authority, as applicable, of a significant change in the physical or mental condition of a resident who has a serious mental illness or mental retardation. The change in condition must affect either the resident's need for continued nursing facility placement or for specialized services. A review and determination under Section 1919(e)(7) of the Act must be done promptly after the nursing facility notifies the state mental health or mental retardation authority of the significant change in condition.

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