Preadmission Screening & Resident Review for Younger Nursing Facility Residents with Serious Mental Illness

The Office of the Inspector General (OIG) sought to determine the extent to which Preadmission Screening & Resident Review (PASRR) evaluations requirements were addressed for Medicaid nursing facility residents between the ages of 22 and 64 with a primary diagnosis of serious mental illness. The OIG reviewed 186 case files of Medicaid nursing facility residents aged 22 to 64 with serious mental illness from four purposively selected nursing facilities per state. The OIG also conducted interviews with State officials, nursing facility staff, and staff at the Centers for Medicare and Medicaid Services.

Only two of the five states selected for the compliance review required that community-based placements be considered when making treatment and service plans for individuals. Only two-thirds of all the selected case files had evidence that individuals with serious mental illnesses had been appropriately evaluated in a Level II PASRR evaluation.