If you are preparing to enter a Medicaid-certified nursing facility, you will be required to complete a Pre-Admission Review (PAR) screening. This consists of two separate pre-admission screening processes: Pre-Admission Screening and Resident Review (PAS) and Level of Care (LOC).

What is PAS?

The PAS component of the federal Pre-Admission Screening and Resident Review (PASRR) requires all applicants for Medicaid-certified facilities, regardless of payment or diagnosis, to be screened for serious mental illness (SMI) and developmental disabilities (DD). This legislation was designed to ensure that individuals with indications of these conditions or disorders receive long-term care in the most appropriate setting.

The PASRR process is completed in HENS which is the Healthcare Electronic Notification System at https://hens.age.ohio.gov/.  The help tab provides user guides as well as user training videos.  You will need a password in order to access the system.  If you do not have a password please contact your facility’s HENS Administrator who can add you to HENS or contact the PAR Unit and a PAR staff member can add you.


What is LOC?

LOC is the State of Ohio's screening process for individuals seeking Medicaid reimbursement for their stay in a Medicaid-certified nursing facility. Medicaid will only pay for an individual's care in a nursing facility if he or she meets the criteria for intermediate level of care or skilled level of care.

How to Submit a Request

Direction Home Akron Canton PAR Representatives conduct paper reviews for LOC assessments submitted from hospitals and nursing facilities. To submit an LOC request, fax the appropriate documentation to our PAR Unit. The fax number is 330.896.6646 and the fax machine is available to receive requests 24 hours a day, seven days a week.

Our PAR staff is available to process requests Monday through Friday from 8 a.m. to 5 p.m. 

Requests for Change of Payer levels of care may be mailed to the Agency, if preferred.

Additional PAR Resources

Please review the following resources to assist you with your request:


**** End of PHE and Impact on PASRR   

Level of Care Rules



For assistance contact the Pre-Admission Review Unit at 1-800-421-7277 ext.8444 or email parrequests@dhad.org.