Preadmission Screening and Resident Review Services

Ensuring the Right Care for Individuals with Intellectual Disabilities, Related Conditions, and Mental Illness

At ACCESS, we provide Preadmission Screening and Resident Review (PASRR) services to individuals seeking placement in a Medicaid-certified nursing facility (NF) or those already residing in one.

PASRR ensures that individuals with intellectual disabilities (ID), related conditions, or mental illness (MI) receive the appropriate care, support, and placement options tailored to their needs.

How PASRR Works

Before an individual can be admitted to a nursing facility, they must complete a PASRR Level 1 (PL1) Screening. This screening applies to all individuals seeking NF placement, regardless of their funding source.

Who Completes the PL1 Screening?

The Referring Entity (RE) is responsible for completing the PL1 form. The RE is the first organization or individual that recommends or refers the person for NF placement. This may include:

Hospitals (most common)
Family members or caregivers
Law enforcement
Physicians’ offices
Community care agencies

Where to Submit the PL1 Form

If the individual qualifies for an Expedited Admission, Exempted Hospital Discharge, or a negative PL1 result, the form is sent directly to the NF with their transfer packet.

If the individual is preadmission positive (suspected of having an ID, MI, or developmental disability (DD) and does not qualify for Expedited or Exempted status), the RE must fax the PL1 form to the Local Authority (LA) for further evaluation.

Find the PL1 Screening Form here under "Long Term Care Programs."

Important PASRR Guidelines

Can the Nursing Facility (NF) Complete the PL1?

No. The NF should never complete the PL1—this is the responsibility of the RE. Allowing an NF to complete the PL1 creates a conflict of interest and violates PASRR regulations, potentially leading to non-compliance sanctions.

What if an NF Refuses to Accept a Resident Who Doesn't Need a PL1?

Even if the NF claims the PL1 is unnecessary, it must still be completed in compliance with Texas Administrative Code and federal regulations.

What Happens After the PL1 Screening?

Once the PL1 is submitted, a PASRR Screening and Evaluation (PE) must be completed within 72 hours by a Local Intellectual Developmental Disability Agency (LIDDA) staff member.

If the individual qualifies for PASRR services, they are assigned a:

PASRR Service Coordinator or
Qualified Intellectual Developmental Professional (QIDP) Case Manager

These specialists work directly with the individual to develop a person-centered Individual Service Plan (ISP) or Recovery Plan based on their unique preferences and needs.

Diversion Slots: Expanding Residential Options

PASRR services also include Diversion Slots, which help individuals transition out of nursing facilities into more independent living environments. Individuals receiving PASRR Service Coordination in an NF may qualify for waiver programs, such as:

Home and Community-Based Services (HCS)
Intermediate Care Facilities (ICF)
Texas Home Living (TxHmL)
And more options to support community-based living

Get Help with PASRR Services

If you or a loved one is considering nursing facility placement or already resides in an NF and may benefit from PASRR services, ACCESS is here to help.

Contact ACCESS at (903) 589-9000 ext. 7450 to learn more about how we can support you through the PASRR process.

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