March 6, 2006

PASRR Screening for Mental Illness in Nursing Facility Applicants and Residents

Karen Linkins, Ph.D., Anna Lucca, Ph.D., Michael Housman, and Shelagh Smith wrote this report which was published in March of 2006. The report states that Medicaid regulations require States to maintain a Preadmission Screening and Resident Review (PASRR) program to screen nursing facility applicants and residents for serious mental illness. The purpose of PASRR is to assess, through progressive screening, whether applicants for nursing facilities have mental illness or retardation, and if the nursing facility is an appropriate placement. For patient who test "positive" in the first test, must continue to treatment in the second test.

The program's intent is to ensure that individuals are placed in the most appropriate setting and have access to specialized mental health services where appropriate. A number of recent studies have questioned the efficacy of the PASRR process in identifying individuals with mental health needs. In the absence of existing studies examining these issues at both the State and nursing home level, the current study attempts to fill an important gap. This report outlines findings from studies conducted by those who were doubtful of the PASRR.