Effectiveness of the PASRR Program Compared With Claims Data in Identifying Nursing Home Admissions With Mental Illness.
Taylor I Bucy, Jenna Case, Donovan T Maust
PMID 42771910WHAT IT FOUND
Only 11.3% of nursing home admissions with claims/encounter-derived serious mental illness had a positive PASRR serious mental illness screen.
Staff should not rely on that flag alone to identify residents who need mental health care planning.
Key findings
01Only 2.4% of nursing home admissions had a PASRR serious mental illness flag, compared with 12.3% having a claims/encounter-derived serious mental illness diagnosis.
02Among admissions with claims/encounter-derived serious mental illness, 11.3% had a positive PASRR serious mental illness screen, and 87.0% had no positive PASRR screen.
03Positive PASRR serious mental illness screens were most common for schizophrenia (19.5%), bipolar disorder (13.5%), and other psychoses (10.2%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is cross-sectional and uses only 2022 nursing home admissions, so it cannot show how PASRR performance changes over time or what happens after admission. Claims and encounter records may underestimate the true prevalence of serious mental illness because they depend on what clinicians coded during care. PASRR data are taken from MDS records, and transfer errors from state records could undercount PASRR-identified serious mental illness. The MDS does not record projected length of stay or PASRR exempted hospital discharge status, so admissions that may bypass screening cannot be examined. The analysis used the full 2022 admission population and did not test statistical significance, so the differences are descriptive rather than inferential.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that the PASRR program causes worse care or that residents without a flag have no mental health needs. The study compares screening flags with claims records, not patient outcomes, and claims records may also miss diagnoses.