PASRR for Families and Caregivers

Are you a person or family member of someone with mental illness and/or intellectual and developmental disabilities who has service and support needs, or a caregiver who provides help to a person with these same needs? If so, you can learn about the Preadmission and Screening Review process below.

What is PASRR?

PASRR is a federally mandated program that requires all states to prescreen all people, regardless of payer source or age, seeking admission to a Medicaid-certified nursing facility. PASRR has three goals:

  1. To identify people, including adults and children, with mental illness, and/or IDD.
  2. To ensure appropriate placement, whether in the community or the nursing facility.
  3. To ensure people receive the required services for mental illness, and/or IDD.


  • Step 1: PASRR level 1 screening (PL1) form
    • A PL1 is required when a person is seeking admission into a Medicaid-certified nursing facility, whether from the community, a hospital, or another nursing facility. The PL1, normally is completed by the person or entity referring them for nursing facility placement, will identify people suspected of having mental illness or IDD. As a family member or caregiver, you might also be the referring entity who completes the PL1.
    • If a suspicion is recorded, the process continues in Step 2. If there is no suspicion, the process ends.
  • Step 2: PASRR evaluation form
    • The PASRR Evaluation is conducted by a qualified and impartial reviewer if the initial PL1 screening records a suspicion that person might have mental illness and/or IDD.
    • People confirmed to have mental illness or IDD are evaluated to determine the need for specialized services and appropriate placement options.
  • Step 3: Interdisciplinary team meeting — for people with a positive PASRR Evaluation
    • You, as a person and/or your family member or caregiver, are an important part of the interdisciplinary team.
    • Your team also includes:
      • Nursing facility staff
      • LIDDA and/or LMHA/LBHA staff
      • Professionals who provide services identified in your plan of care
    • The purpose of the interdisciplinary team meeting is to discuss and agree on:
      • Services and supports
      • Appropriate living environment

PASRR Specialized Services and Supports

People with a positive PASRR Evaluation are eligible for a variety of specialized services and supports.

  • Nursing facility services and supports for people with intellectual and/or developmental disabilities include but are not limited to:
    • Durable medical equipment
    • Habilitative therapies (such as speech therapy, physical therapy or occupational therapy)
    • Assessments
  • LIDDA services and supports for people with IDD include but are not limited to:
    • Independent living skills
    • Day habilitation
    • Habilitation coordination
  • LMHA/LBHA services and supports for persons with mental illness include but are not limited to:
    • Skills training
    • Psychosocial rehabilitation

These services will be explained in full during the PASRR Evaluation process and during the interdisciplinary team. To learn more, visit the LMHA/LBHA PASRR webpage or the PASRR Specialized Services Providers webpage.

What are the available living options through PASRR?

  • Living options for PASRR positive people with IDD include:
    • Intermediate Care Facilities: Six-bed homes in the community.
    • State Supported Living Centers: Large facilities for people with high needs.
    • Community First Choice: Attendant and habilitative services in their own or family home.
    • Home and Community Based Services: Attendant and habilitative services in their own or family home, host home or group home.
    • Texas Home Living: Attendant and habilitative services in their own or family home.
    • Community Living Assistance and Support Services Program: Attendant and habilitative services in their own or family home.
    • Deaf Blind with Multiple Disabilities Program: Recipients can live in their own home, family home or in a group home of no more than six people.
  • For PASRR positive people with mental illness:
    • If there is a housing need for people with mental illness, your LMHA/LBHA can discuss how those needs can be met.

General Resources

Locate your local LIDDA or LMHA/LBHA

Do you have more questions or want to learn more?
Find out whom in your area you can contact for help by locating your local LIDDA or LMHA/LBHA.

Contact HHS about PASRR

For IDD support contact PASRR Support.