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 Screening For Mental
Illness in Nursing Facility Applicants: Understanding Federal
RequirementsMedicaid law and
regulations require States to have a Preadmission Screening and
Resident Review (PASRR) program to determine whether nursing
facility applicants and residents require nursing facility
services and specialized mental health care. Congress developed
the PASRR program to prevent inappropriate admission and retention
of people with mental disabilities in nursing facilities, as part
of the Omnibus Budget Reconciliation Act (OBRA) 1987. Several
recent studies raise questions concerning the effectiveness of the
PASRR program, suggesting that the program creates barriers for
persons requiring nursing facility placements and does not ensure
access to appropriate psychiatric services.
As part of a larger
evaluation of the PASRR program, this paper reviews the literature
concerning PASRR and mental health services for persons in nursing
facilities. It details the Federal laws and regulations concerning
PASRR, reviews key policy issues from the literature, clarifies
frequently asked questions regarding the process, and identifies
additional policy questions to be studied. 
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