A Comprehensive Review of PASSR

Understanding the federal requirements for screening mental illness in nursing facility applicants can prove a complicated process for state and local authorities as well as nursing facility administrators and staff. To prevent the inappropriate admission and retention of people with mental disabilities in nursing facilities, Medicaid law and regulations require that states maintain a Preadmission Screening and Resident Review (PASRR) program. PASRR determinations are particularly important, given the 1999 Olmstead Supreme Court decision mandating that states provide community-based treatment options for people with mental disabilities when treatment professionals deem them appropriate.

The Lewin Group recently completed a comprehensive analysis of PASRR policy. The report, Screening for Mental Illness in Nursing Facility Applicants: Understanding Federal Requirements, details the federal law and regulations as well as state guidance concerning PASRR, reviews key policy issues from the literature, clarifies frequently asked questions regarding the process, and identifies further policy questions to be studied. Key report findings include:

• PASRR implementation varies widely across states.
• Funding PASRR screens and specialized treatment challenges states.
• Individuals with Alzheimer's disease and related dementias present unique challenges for nursing facilities.

Also, on behalf of the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Medicare and Medicaid Services (CMS), The Lewin Group currently is conducting a national survey of state Mental Health and Medicaid agencies. The study seeks to better understand how PASRR has affected the identification of people with serious mental illness in nursing facilities and their need for and receipt of mental health care.

View the full report, Screening for Mental Illness in Nursing Facility Applicants: Understanding Federal Requirements, on SAMHSA's Center for Mental Health Services Web site. For more information on this project, contact Karen Linkins.