FAQs

Maximus performs Pre-Admission Screening and Resident Review (PASRR) Level I screens and Level II evaluations on individuals who are applying to or residing in Medicaid-certified nursing homes.

This federally mandated assessment process is used to determine whether the nursing home is the appropriate placement for individuals with mental illness, intellectual disabilities, or developmental disabilities. PASRR functions as an essential method to help match individuals with the care and services they need. Maximus also performs nursing facility Level of Care Determinations for all Level II evaluations.

Contact the Tennessee PASRR Help Desk:

The Tennessee PASRR Program Office operates from 7:00 am - 4:00 pm CST, Monday through Friday. 

Our goal is to complete Level II assessments within 5 business days from the date you submit the Level of Care screen. If you have not yet received an outcome on a Level II, reach out to the Maximus Help Desk (833.617.2777). We are happy to give you a status update on the review.

If the person will be admitting to a TN Medicaid-certified nursing facility, they must have a TN Level I and Level II (if the Level I identifies the need for a Level II) prior to admission to the TN nursing facility. The receiving facility will need to submit the Level I prior to admission and the process for Level II completion will be slightly different if the person is not within the TN state borders, although the Level II must still be completed prior to NF admission. You will need to contact the referring facility and request the following: MARS, H&P, Psych evaluation (if available) and 2 weeks of nurses’ notes (or whatever is available). You will then submit the request and upload the required documents.

If a Level II is completed and an approval for nursing facility care is issued, it will be a short-term approval. At the expiration of the short-term approval, if more nursing facility care is needed please submit a new Level I and a face to face to Level II assessment will be completed.

NF Applicant (Preadmission):

  • The NF may not accept a new resident without a complete Level I (and Level II, if needed).

NF Resident (Resident Review):

  • If a person goes to a hospital for a medical reason and returns to the nursing facility no new Level I/Level II is required.
  • If a person goes to a psychiatric hospital and returns to the NF, a new Level I/Level II is required before returning to the NF.
  • If a person transfers from one NF to a different NF without a discharge to the community, no new Level I/Level II is required, as long as there is no significant change in mental status.
  • If a person transfers from one NF to a different NF and has a hospital admission between the two NFs, no new Level I/Level II is required, as long as there is no significant change in mental status.
  • If a person discharges from the NF to home or other community placement—even for one day—a new Level I/Level II is required.

If someone from the Home Health Agency is a registered user of Maximus’s system, they can submit the Level I. Many Home Health Agencies will not have registered system users, so we encourage the agencies to work closely with the MCO, AAAD, hospital, and/or nursing facility staff to ensure the Level I is complete prior to NF admission.

Every person going to a Medicaid-Certified NF will require a Level I prior to NF admission. If the person has a sole or primary dementia diagnosis, no Level II will be required. If Maximus’s clinicians question the dementia primacy, a Level II may be required for a PASRR determination. For persons with co-occurring dementia and serious mental illness, you must submit substantiating documentation to validate the dementia diagnosis, such as neurocognitive testing, neuropsychiatric evaluation, scans, etc.

A new Level I is not required if the individual is transferring from NF to NF without interruption in the level of service, in other words, no discharge to the community. NF providers can update discharges, transfers, and admissions in PathTracker. As long as there has been no change in mental health status or level of care, and as long as the initialLevel I/Level II approval was not time-limited, a Level I is good indefinitely.

If a person experiences a Status Change, a new LI is required before transferring to a new NF. If the individual has a Level II condition or found to have a Level II condition via the Status Change review, a Level I and LOC are required to refer for a Level II evaluation.

If a person discharges from a NF to a community placement, and then needs to return to the same or different NF, a new Level I is required. If the individual has a Level II condition, a new Level I and LOC are required.

Federal regulations require every person entering a Medicaid-Certified NF to have a completed Level I (and Level II, if needed) prior to admission, regardless of pay source.