Preadmission Screening and Resident Review (PASRR) | State Mental Health Authority (SMHA)
The Behavioral Health Administration acts as the State Mental Health Authority (SMHA) for the federally required Preadmission Screening and Resident Review (PASRR) program for individuals entering Medicaid Certified Nursing Facilities within Colorado, which is managed by the Colorado Department of Health Care Policy and Finance.
Last updated: July 3, 2025
About SMHA
The SMHA is responsible for making the Mental Illness (MI) and Specialized Services (SS) determinations, based upon an evaluation conducted by an independent entity. The SMHA makes timely determinations based on these independent Level II evaluations of NF applicants and residents. Determinations made by the SMHA are based upon the above evaluations and contain all required information including any behavioral health needs that are to be addressed in the Nursing Facility (NF) plan of care.
Although the SMHA does not perform the evaluation, it receives the evaluation report and as a practical matter, the report may be part of or attached to the determination notice issued by the SMHA. The SMHA notifies the State Medicaid Agency (SMA) of any NF residents with Serious Mental Illness (SMI) whom the SMHA becomes aware of that did not receive a Level II evaluation before admission, and any problems with PASRR that are the SMHA's responsibility to address.
PASRR determinations made by the SMHA cannot be countermanded by the SMA through the claims payment process or through other utilization control/review processes, or by the Colorado Department of Public Health and Environment (CDPHE), survey and certification agency, or by any receiving facility or other involved entities.
Learn more about the Colorado PASRR program.
What is PASRR?
Pre-admission Screening and Resident Review (PASRR) is a federally required program to help ensure that individuals are not inappropriately placed in nursing homes for long term care. PASRR requires that:
- All applicants to a Medicaid-certified nursing facility be evaluated for serious mental illness (SMI) and/or intellectual disability.
- Individuals are offered the most appropriate setting for their needs (in the community, a nursing facility, or acute care settings).
- Individuals receive the services they need in those settings.
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, individuals with disabilities cannot be required to be institutionalized to receive public benefits that could be furnished in community-based settings. PASRR can also advance person-centered care planning by assuring that psychiatric and disability needs as well as functional impairments are considered along with personal goals and preferences in planning long term care.
In brief, the PASRR process requires that all applicants to Medicaid-certified nursing facilities be given a preliminary assessment to determine whether they might have SMI or (ID). This is called a "Level I screen." Those individuals who test positive at Level I are then evaluated in depth, called "Level II Assessment". The results of this evaluation result in a determination of need, determination of appropriate care setting, and a set of identified specialized services to inform the individual's plan of care. Regulations governing PASRR are found in the Code of Federal Regulations, primarily at 42 CFR 483.100-138.
Training
On demand PASRR training, live training recordings, tutorial videos, and desk-reference documents are all available through Colorado’s PASRR vendor, Maximus.
Training resources posted on the Maximus provider website are relevant for nursing facility staff, hospital case managers and discharge planners, single-entry point medicaid case management agency staff and anyone else involved in the PASRR and nursing facility admission process.
Occasionally, additional virtual trainings are held and all training events/opportunities are listed on the PASRR program event calendar.
Please contact BHA’s PASRR manager, Chellie Voss, at michelle.voss@state.co.us if you need assistance identifying which training may be most helpful for you.
PASRR Technical Assistance Center
The PASRR Technical Assistance Center helps states fulfill the goals of Pre-admission Screening and Resident Review, and family members, individuals, and providers can access background information and tools related to PASRR.
How to submit PASRR documents
Visit the Department of Health Care Policy & Financing's Pre-admission Screening and Resident Review Program webpage. Click on the training tab for instructions on how to establish a user account for the new PASRR vendor (Maximus), recordings from training conducted in May/June 2025 as well as resources from Maximus including a step-by-step screenshot guides for Level I submissions in their electronic PASRR portal, AssessmentPro.
Find the status of a triggered PASRR Level II
Access Maximus’ AssessmentPro portal and view the status of any review that you have created yourself or any reviews that your facility is currently working on. If you need additional assistance checking the status of a review, you may call the Maximus Help Desk at 833-588-7787 or email the help desk at COPASRR@maximus.com.
Contact
To inquire more about PASRR Mental Illness (MI) Specialized Services (SS) and Nursing Facility (NF) determinations, please contact:
Chellie Voss, PsyD, LPC
OBRA | PASRR Manager
Behavioral Health Administration
michelle.voss@state.co.us | 720-646-2881