The PASRR Technical Assistance Center helps states fulfill the goals of Preadmission Screening and Resident Review

How long should PASRR records be retained?

42 CFR 483.130(o) has this to say about the retention of PASRR records:

The State PASARR system must maintain records of evaluations and determinations, regardless of whether they are performed categorically or individually, in order to support its determinations and actions and to protect the appeal rights of individuals subjected to PASARR.

Note that no time frame is given. Often state counsel makes the decision about record retention, typically in the context of broader decisions about medical record-keeping.

State-specific requirements aside, there are several issues to keep in mind when thinking about how long to retain PASRR records.

First, several parties keeping PASRR records, and several distinct bits of data that might count as PASRR records.

  • NFs: The NF should keep PASRR records for the duration of the individual’s NF stay, including transferring PASRR records to another NF if the individual should transfer to another NF.
  • Vendors of PASRR services: In the contracts that many vendors have with states, the minimum length of time that PASRR individual records must be kept ranges from 7 to 10 years.
  • State policy makers: It would seem prudent for a state to maintain particular PASRR variables much longer for trend and policy analysis. This might include all episode, outcome, and decision factor variables.

Second, there are programmatic issues to consider. To be effective, the PASRR program needs data on Level II individuals for many purposes, included but not limited to:

  1. Knowing where level II residents are so state can monitor that recommended services are being delivered.
  2. Knowing where level II residents are in order to provide the survey agency with a list of level II residents so one can be included in the sample for a NF survey
  3. Knowing how to respond when a facility calls with a possible referral upon SCSA (unless the PASRR staff can pull the level II file how can they decide if a significant change requires a new evaluation?)
  4. A variety of purposes in overall quality monitoring of the program
  5. Public health information and policy planning. The level IIs represent an incredibly detailed source of information on 100% sample of individuals with SMI in NFs, including who is admitted, and changes over time.

Part of the issue has to do with the usefulness of records. A 100% paper system of file folders will not easily support the above requirements. It may be that case records suitable for legal purposes can be discarded once appeal rights have ended, but information derived from those records stored in a database should be retained for a longer period to promote objectives such as those above.

PTAC currently serves as a contractor for CMS.
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