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This section contains resources for states and providers on PASRR processes during natural disasters and emergency situations.


Can PASRR requirements be waived during an emergency?

March 20, 2020


PASRR requirements cannot be waived or suspended in an emergency unless the state receives authority to do so under an 1135 waiver. Under Section 1135 of the Social Security Act, the HHS Secretary may be authorized to take certain actions during eligible major disasters or emergencies. These actions may include temporarily waiving or modifying certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements to help meet the needs of eligible individuals and providers living in emergency areas. Additional information about 1135 waivers can be found on the Section 1135 Waiver Flexibilities webpage on, located at:

PASRR Activities During an Active Emergency

May 17, 2019


This paper builds on the Coverage Learning Collaborative guidance from the Centers for Medicare & Medicaid Services (CMS) on how states can support Medicaid operations and enrollees in times of emergency but focuses on options for addressing Preadmission Screening and Resident Review (PASRR) requirements. The purpose of this paper is to clarify the range of options that states have for addressing PASRR responsibilities, including those that do not require waiving PASRR requirements as part of an 1135 waiver. PASRR scenarios have been included to address common questions raised by nursing facilities (NFs) in past emergencies. This paper supersedes prior Center for Clinical Standards and Quality All-Hazards guidance.

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