The PASRR is a federally mandated screening process for individuals with serious mental illness and/or intellectual disability/developmental disability related diagnosis who apply or reside in Medicaid Certified beds in a nursing facility regardless of the source of payment. The screening assures appropriate placement of persons known or suspected of having a mental impairment(s) and also that the individual needs of mentally impaired persons can be and are being met in the appropriate placement environment.

The online PASRR training provides the following information: contact information, overview, types of admissions, DA-124 A/B and DA-124C form explanations, special admission categories, assessed needs, and much more.

If you have questions, contact the Central Office Medical Review Unit (COMRU) at 573-522-3092 or

Application started after 07-17-2023

Application started prior to 07-16-2023

New LOC Process Training - Level One Form
New LOC Process Training - NF Level of Care Assessment
New Online Process - Questions and Answers
New LOC Webex Training
Updated Online Process Training (Nov 2022)

DA 124A/B
DA 124C
DA 124 Application Request Form (Sunshine Request)
Changes in Status
Change in Status Flowsheet
Hospital to Skilled Nursing Facility Flowsheet
Intellectual Disability and Developmental Disabilities Sheet
Special Admission Category Referral (08/2020)
What to Submit to COMRU for client entering a Skilled Nursing Facility
What would trigger a Level II Review