This report outlines the findings from the second phase of a two-part study, which involved a national survey of the relevant agencies in all 50 States and the District of Columbia to determine how they have organized and administered Federal requirements under PASRR.
The first phase of this study involved a review of the existing literature on PASRR and of the mental health services for those in nursing facilities. That review was published as a Substance Abuse and Mental Health Services Administration (SAMHSA) separate report, Screening for Mental Illness in Nursing Facility Applicants: Understanding Federal Requirements (Linkins et al., 2001).
The second phase of the study also included case studies of four States, which were selected to include each of the entities that conduct Level II screens: private mental health agencies, community mental health centers, individual mental health practitioners, and referring agencies or State agencies. In each State, a total of six nursing homes were selected, with three located in an urban county and three located in a rural county. In each of those 24 nursing facilities, the administrators were interviewed about the PASRR process, and the medical records for the nursing facility residents were reviewed. In two of the four States, clinical interviews were conducted with a total of approximately 50 nursing facility residents.