SPECIAL BULLETIN COVID-19 #71: Extension of Temporary Suspension of Level I and Level II Assessments for New Nursing Home Admissions

Thursday, April 30, 2020

Preadmission Screening and Resident Review (PASRR)

NC Medicaid temporarily suspended the requirement of Level I and Level II Preadmission Screening and Resident Reviews (PASRRs) for new nursing home admissions as well as the requirement of a PASRR number on the prior approval (PA).  The temporary suspension was due to COVID-19 and was in effect from March 25 – April 24, 2020, as noted in SPECIAL BULLETIN COVID-19 #15: Medicaid and NC Health Choice Temporary Flexibilities - 1135 Waiver Provisions.

Effective April 25, 2020, the temporary suspension of Level I and Level II PASRRs has been extended for new admissions. If the individual is expected to remain in the nursing facility for more than 30 days, a notice of the need for a PASRR review should be submitted through NCMUST. In addition, individuals transferred from one nursing facility to another nursing facility as a result of COVID-19 will continue to not be considered a new admission and will not need a PASRR. The transferring nursing facility must ensure that all copies of the resident’s PASRR paperwork (including any Level II information) is transferred with the individual.

The temporary suspension of the requirement of a PASRR number on a PA is also extended. Providers should continue to enter the number “8888” in place of the PASRR number when submitting a PA to NCTracks for approval. Providers should add all the pertinent information about the beneficiary’s level of care needs in their portal submission. 

For individuals receiving specialized services, the nursing facility should focus on promoting the basic health and safety of individuals who had been receiving specialized services in the nursing facility before the COVID-19 public health emergency or who were receiving specialized services in another nursing facility before the transfer. The admitting nursing facility continues to be responsible for submitting a claim for payment. The health and safety of facility staff and the Medicaid beneficiaries served by a facility are of prime importance. In the event the facility is affected by COVID-19, please implement the facility’s emergency plan.

The above temporary changes are effective April 25, 2020 and will end the earlier of the cancellation of the North Carolina state of emergency declaration or when this policy is rescinded.

Incomplete PASRR Submissions

To assist with processing PASRR screens timely and efficiently, all PASRR screens that are not fully and accurately completed after a 3rd request for additional information from the PASRR nurse will not be processed. The case will be closed, and the provider will need to resubmit. Multiple requests for information negatively impact the review process and increases the response time to authorize a PASRR request.


In accordance with our approved annual plan, the North Carolina Medicaid Uniform Screening Tool (NCMUST) PASRR team will be performing an audit of all current organizations, admins and users of the system. This audit will be performed in more than one phase.

The objectives of this audit are to:

  • Identify Active Organizations (those registered facilities which actively submit PASRR screens in the NCMUST application)
  • Identify and confirm Organization Admins
  • Ensure only active users have access to NCMUST

The scope of the audit will include identifying and taking steps to ensure only active organizations are listed within NCMUST and to ensure any inactive user or admin is removed from the system.

Should you have any questions, please contact uspquestions@dhhs.nc.gov.