FAQs

To be added to the Maine PASRR Help Desk distribution list, email a request to MEASAPASRR@maximus.com with the subject line: “Please add my email to the Maine PASRR Contact List.” This communication should include your name, title, agency/facility, email address, and contact phone number.

Note - Once you become a registered Maximus system user, you will automatically be added to the distribution list.

To find answers to your PASRR program questions, call the Maine PASRR Help Desk at 833.525.5784 (Choose Option 3) or contact Maximus via email:

General PASRR questions: MEASAPASRR@maximus.com

Preadmission Screening and Resident Review (PASRR) is a federally mandated screening and assessment program dating back to 1987. PASRR was created as a part of the Omnibus Budget Reconciliation Act (OBRA), also known as the Nursing Home Reform Act, in response to transinstitutionalization and quality improvement efforts. PASRR requirements were also added to the Social Security Act at sections 1919 (b)(3) (F) and 1919 (e) (7).

The goal of PASRR is to optimize an individual’s placement success, treatment success, and ultimately, their quality of life.

PASRR was established as part of the de-institutionalization process to ensure people with disabilities (i.e., Serious Mental Illness, Intellectual and/or a Related Condition):

  • are not inappropriately institutionalized in a NF
  • receive services in the least restrictive setting, and that
  • needed services/supports are identified for the NF to provide.

PASRR is an important tool for states to use in rebalancing services away from institutions and towards supporting people in their homes, and to comply with the Supreme Court decision, Olmstead vs L.C. (1999). Under the Americans with Disabilities Act (ADA), individuals with disabilities cannot be required to be institutionalized to receive public benefits that could be furnished in community- based settings. 

The PASRR process requires that all applicants to Medicaid-certified nursing facilities be given a preadmission, preliminary, screening to determine whether they might have Serious Mental Illness (SMI) or an Intellectual Disability (ID) or an Other Related Condition (ORC). This is called a "Level I Screen." The person may also require a preadmission Level II PASRR assessment.

Individuals whose Level I screen shows indicators of SMI/ID/ORC will receive a clinical review to determine if an in-depth evaluation called a "Level II" is needed prior to nursing facility (NF) admission, or if it can be delayed or the person exempted.

When a comprehensive Level II assessment is needed, it results in a determination as to whether the person has a qualifying PASRR condition, the appropriateness of the NF setting, and, as appropriate, any specialized (disability-specific) services needed.

Everyone seeking entry into a Medicaid certified NF, regardless of payer source, diagnoses, or current location, must be screened prior to NF admission.

Yes. Everyone seeking a NF stay, regardless of known/unknown or suspected disability status, must be screened. Submit all Level I Screens via AssessmentPro.

The Level I Screen is built to help directly identify those that may meet specific criteria for PASRR inclusion, removing any subjectivity or responsibility of this determination from the submitter. If the absence of a SMI cannot be discerned by Maximus, the individual will be referred for a Level II assessment.

Most Level I outcomes are available immediately. About 30% will need to undergo a clinical review. For those requiring a clinical review, the expected turnaround time is one (1) business day or less from referral.

Maximus encourages providers to begin discharge planning as soon as possible. If the provider thinks the person might need NF placement, they should submit the Level I. This prevents delays in discharge if the process determines the person also needs a Level II assessment. The expected turnaround time for a Level II is seven (7) business days or less from referral. 

If a Medicaid certified nursing facility (NF) admits someone without a PASRR Level I Screen (and in some cases also a Level II assessment), the NF is out of compliance with state and federal law. A Level I should immediately be submitted.

This puts the facility at risk of deficient/noncompliant findings during LTC surveys. Regulations also allow for CMS/state recoupment of money for services paid prior to PASRR completion. 

A Level II assessment is an in-depth assessment which determines if a person has a qualifying PASRR condition (i.e., Serious Mental Illness (SMI), Intellectual Disability (ID) and/or Other Related Condition (ORC)), and if so, whether the person requires the level of service provided by a NF and also, whether or not the individual requires specialized services for their qualifying PASRR condition. Maximus assessors will conduct Level II assessments. 

After Maximus receives the completed Level II assessment, our Clinicians review the information submitted by the assessor, including the supporting documentation and interview data, from which a Summary of Findings is created.

This assessment summary, will be added to the “determination packet” which also includes:

  • A cover letter stating the outcome (whether NF admission is approved or denied +any specialized services identified)
  • An outcome explanation letter
  • Appeal rights