Serious Mental Illness in Nursing Homes: Stakeholder Perspectives on the Federal Preadmission Screening Program
Open accessAbstract
The federal Preadmission Screening and Resident Review (PASRR) program was enacted in the 1980s amid concerns surrounding the quality of nursing home (NH) care. This program is meant to serve as a tool to assist with level of care determinations for NH applicants with serious mental illness (SMI) and was intended to limit the growth in the number of NH residents with SMI. Despite this policy effort, the prevalence of SMI in NHs has continued to increase, and little is known about the mechanisms driving the heterogeneous and suboptimal administration of the PASRR program, absent routine evaluative efforts. We conducted 20 semi-structured interviews with state and national stakeholders to identify factors affecting PASRR program administration and NH care for residents with SMI. Stakeholders expressed concern regarding fragmentation, specifically lack of clarity in the value of assessments beyond a regulatory requirement. Additionally, they cited variable program administration as contributing to fragmented communication patterns and inconsistent training across jurisdictions. Given the number of people with SMI currently residing in NHs, policy and practice should take a person-centered approach to assess how PASRR can be better used to support resident needs.
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Lifetime risk and persistence of psychiatric disorders across ethnic groups in the United States
BRESLAU, J., KENDLER, K. S., SU, M., GAXIOLA-AGUILAR, S., & KESSLER, R. C. (2005) · Psychological Medicine · doi:10.1017/s0033291704003514 · Cited by 642 · cited 2× · see citing works
“While the rate of mental health diagnoses is similar between Black and White adults in the U.S., mental disorders are “more severe, persistent, and disabling” among Black and Hispanics (Alang, 2019; Breslau et al., 2005; Williams et al., 2007).”
BackgroundDisparities in mental health service use of racial and ethnic minority elderly adults
Jimenez, D. E., Cook, B., Bartels, S. J., & Alegría, M. (2013) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12063 · Cited by 201 · see citing works
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- Authors
- Bucy, T., Moeller, K., Skarphol, T., Shippee, N., Bowblis, J. R., Winkelman, T., & Shippee, T.
- Affiliations
- University of Minnesota (US)
- Miami University (US)
- Corresponding author
- Bucy, Taylor
- Venue
- Journal of Aging & Social Policy
- Publisher
- Informa UK Limited
- Published
- 2022-07-03
- Volume
- 34
- Issue
- 5
- Pages
- 769-787
- ISSN
- 0895-9420 (ISSN-L)
- 1545-0821
- PMC
- PMC9709959
- OpenAlex
- W4283787959
- Cited by
- 8
- References
- 2
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 3
- FWCI
- 2.01
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Aging & Social Policy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Minority Health and Health Disparities (5R01MD010729-05S1)
- Topics
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- severe mental illness, nursing homes, long-term care quality, stakeholder perspectives, program management, fragmentation, person-centred care, mental health policy
- MeSH terms
- Mental Disorders, Humans, Nursing Homes, Prevalence
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