NC PASRR FAQs and Definitions
- SMI - or Serious Mental Illness, is evident if an individual is known or suspected to have a
combination of a major psychiatric condition and a recent history of treatment for, and/or
symptoms of that condition. A primary diagnosis of dementia or a sole psychiatric diagnosis
of an organic disorder is excluded.
- IDD, or Intellectual or Developmental Disabilities, involves a measure of intellectual functioning that exists
concurrently with adaptive functioning deficits.
- RC - or a Related Condition, is any severe or chronic disability such as cerebral palsy,
or a head injury that manifests itself prior to age 22, continues indefinitely, and results in
substantial functional limitations.
Frequently Asked Questions
- How do I register to submit PASRR screenings?
- How do I update my information on the North Carolina Medicaid Uniform Screening Tool (NC MUST) website?
- How do I correct mistakes on a PASRR screening form?
- What is a USP ID?
- When would I require a USP ID?
- What do we do about screens in a running status?
- How do we get PASRR request expedited?
- What documentation is needed for Level II PASRR's?
- What is a change in condition?
- Does everyone entering into an ACH require a PASRR?
- What do the PASRR authorization codes mean?
- Are the PASRR authorizations transferable from one facility to another?
- Does a 30 day PASRR request require physician signature?
- Can a 30 day authorization be given for anyone?
Frequently Asked Questions Answers
- 1. How do I register to submit PASRR screenings?
- For detailed instructions on how to register please contact our NC PASRR helpdesk at 1-855-883-8018.
- 2. How do I update my information on the North Carolina Medicaid Uniform Screening Tool (NC MUST) website?
- To update demographic information please contact our NC MUST helpdesk at 1-855-883-8018.
- 3. How do I correct mistakes on a PASRR screening form?
- Corrections can only be made to the screening form prior to submission. Once a screening form has been submitted corrections cannot be made and a new form will be required.
- 4. What is a USP ID?
- A USP ID or Uniform Screening Program Identification is a unique identifying number assigned by the NC MUST application for an individual being screened. Unlike the MUST ID an individual applicant only receives one USP ID.
- 5. When would I require a USP ID?
If the applicant does not have a SSN, you are required to contact the NC PASRR helpdesk to obtain a USP ID which will be used in place of a SSN
- 6. What do we do about screens in a running status?
If you have submitted a screening form into NC MUST and the status is shown as "running" then please call the NC PASRR helpdesk at 1-855-883-8018 for a status reset.
- 7. How do we get PASRR request expedited?
PASRR requests are not expedited. Authorizations are reviewed on a first come first serve basis. Any requests to expedite are reviewed on a case-by-case basis by our clinical review staff and granted at the discretion of leadership.
- 8. What documentation is needed for Level II PASRR's?
All Level II PASRR requests require a most recent copy of the patients History & Physical (H&P), North Carolina FL2 form, and Psychological consult or evaluation if available. In addition to the aforementioned documentation an ACH Level II PASRR request requires a completed signed Consent to Participate.
- 9. What is a change in condition?
A significant change is defined "as a major change in the resident's status that results either in an improvement or deterioration in at least two (2) or more areas of the resident's physical or mental functioning, which has an impact on the resident's specialized needs" for more information please review the nursing facility clinical coverage policy 2B1 located at:
- 10. Does everyone entering into an ACH require a PASRR?
No, the PASRR process is only required for Medicaid eligible individuals entering into an Adult Care Home.
- 11. What do the PASRR authorization codes mean?
PASRR authorizations determine approval, denial along with corresponding time frames and/or restrictions for placement into a Skilled Nursing Facility or Adult Care Home. (Please see PASRR Authorization Codes Handout)
- 12. Are the PASRR authorizations transferable from one facility to another?
PASRR authorizations are transferable only from same level of care facilities or from one facility to another provided the patient is maintaining the same level of care
i.e. An individual at a skilled nursing facility cannot use their existing skilled PASRR authorization for admission into an Adult Care Home and vice versa.
- 13. Does a 30 day PASRR request require physician signature?
All PASRR request for a 30 day time-limited categorical stay in the skilled nursing facility requires the signature of either the patient's Primary Care Physician (PCP) or attending physician
- 14. Can a 30 day authorization be given for anyone?
30 day time-limited PASRR authorizations are only given to individuals that would otherwise require a full Level II evaluation but have been exempted through physician certification.
These authorizations are only for rehabilitative services at a Skilled Nursing Facility (SNF) and are not applicable for Adult Care Home Admissions (ACH).