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Division of Mental Health Services

Office of Geriatrics, Emergency Services & PASRR

Mental Health and Elder Care

Preadmission Screening and Resident Review
TDMH coordinates the federally mandated Level II PASRR (Preadmission Screening and Residential Review) process as a component of the application process for admission to Tennessee's nursing homes.

The Department oversees the ' Mental Health ' PASRR evaluations in accordance with the Omnibus Budget Reconciliation Act of 1987. This legislation mandates all individuals entering a nursing home who have a mental illness, mental retardation, or a related condition to be screened before entering a nursing home.

This screening determines whether the individual’s mental health and/or disability related needs can be met in the nursing home. Recommendations are made to ensure that their needs are met. If they cannot be met and need specialized services other than the nursing home, a determination is made with the appropriate recommendations.

The department also ensures evaluations are performed as necessary for these individuals after a nursing home admission and reviews on individuals living in nursing homes are conducted as appropriate.

PASRR Process in Tennessee
In Tennessee most PASRR evaluations are completed as part of the application process to a nursing home.
If an individual applying for a nursing home is approved medically by the TennCare/Long Term Care Unit for nursing home placement, a request for a Level II PASRR is made if indicated by the application process.
The department refers all appropriate requests to their contractor for evaluation. Evaluations consist of on-site visits and review of all clinical materials by licensed psychiatrists or in the case of developmental disabilities, a licensed psychologist.

Based on all the clinical information presented, the doctor makes a determination. This determination is either that the applicant needs specialized services that the nursing home cannot provide and must receive them elsewhere or that the applicant does not need specialized services and can receive the necessary treatment at the facility.

Specialized services are defined as mental health services or rehabilitative services that cannot be obtained in the nursing home and are part of a continuous treatment plan.

After the determination is made the department reviews and approves the evaluation. The evaluation is then returned to TennCare who completes the process and informs the appropriate individuals.

Appeals of determinations are made through the Department of TennCare, Long TermCare division.

Other PASRR evaluations completed on individuals occur on request of the nursing home or as a part of a yearly review process.

Mental Health Guide for Older Adults (PDF)

Needs of Older Americans (PDF)

Other Links
The National Association of PASRR Professionals
Division of Mental Retardation Services
Long Term Care