California Department of Health Care Services (DHCS), PASRR Section

Pre-Admission ​Screening and Resident Review


The Nursing Home Reform Act was passed as part of the Omnibus Budget Reconciliation Act of 1987 (OBRA-87), and amended by Public Law 100-203 and 101-508, creating the Pre-Admission Screening and Resident Review (PASRR) process. (Refer to the Code of Federal Regulations (CFR) title 42, part 483, sections 483.100-483.138 to view PASRR regulations).

The California Department of Health Care Services (DHCS), PASRR Section is responsible for determining if individuals with serious mental illness (SMI) and/or intellectual/developmental disability (ID/DD) or related conditions (RC) require:

  • Nursing facility services, considering the least restrictive setting
  • Specialized services

This is achieved by completing the PASRR process. The PASRR process consists of a Level I Screening, Level II Evaluation, and a final Determination.

Level I Screening

The Screening is submitted online by the facility and is a tool that helps identify possible SMI and/or ID/DD/RC.

Level II Evaluation

If the Screening is positive for possible SMI and/or ID/DD/RC, then a Level II Evaluation will be performed. The Level II Evaluation helps determine placement and specialized services. The Department of Health Care Services (DHCS) is responsible for SMI Level II Evaluations, which by law must be performed by a third party contractor, Kepro. The Department of Developmental Services (DDS) is responsible for ID/DD/RC Evaluations.


The SMI Determination will be available online and will include placement and treatment recommendations for the individual. The ID/DD/RC Determinations will be issued by DDS, please contact DDS for questions regarding the Determination.