Miletree Center: PASARR Screening Failures Cited - WV
Federal health inspectors visited Miletree Center on August 18, 2025, responding to a complaint. By the time they left, they had cited the facility for 10 separate deficiencies. One of them involved the Pre-Admission Screening and Resident Review process, known as PASARR, which exists to protect some of the most vulnerable people in long-term care.
The PASARR requirement isn't a formality. It is the mechanism by which states are supposed to identify nursing home residents who have serious mental illness or intellectual disabilities and ensure those residents receive appropriate care, or are redirected to a setting better suited to their needs. When a facility fails to conduct or document proper PASARR screenings, residents can end up in the wrong level of care, without the specialized services they need, sometimes for months or years before anyone catches it.
Inspectors classified the deficiency at Miletree Center as scope and severity level D, meaning it was an isolated finding with no documented actual harm but with potential for more than minimal harm to residents. That classification sits at the lower end of the severity scale, but it does not mean the finding is inconsequential. A resident placed in a nursing facility without proper screening for a mental disorder or intellectual disability may be receiving care that doesn't address their actual diagnosis, or may be living in an environment that actively works against their wellbeing.
The facility reported a correction date of September 17, 2025, roughly a month after inspectors left.
Miletree Center is a nursing facility in Spencer, the county seat of Roane County, a rural community in central West Virginia. Roane County has no psychiatric hospital and limited outpatient mental health infrastructure. For residents with serious mental illness or intellectual disabilities, a nursing facility may be the only option within a reasonable distance, which makes the accuracy of PASARR screening even more consequential. A resident who needs a level of psychiatric care that Miletree cannot provide has few alternatives nearby.
The inspection that surfaced the PASARR deficiency was a complaint inspection, meaning someone, whether a resident, a family member, a staff member, or another party, contacted regulators with a concern serious enough to prompt a visit. Complaint inspections are targeted, not comprehensive surveys of every aspect of care, which means the 10 deficiencies inspectors found represent what they were able to document during the scope of that visit.
PASARR has been a persistent weak point in nursing home oversight nationally. Studies and federal audits have found that states and facilities alike have struggled to implement the screening process consistently, that screenings are sometimes conducted superficially, and that residents who do receive a Level II evaluation requiring specialized services often don't receive those services in practice. The gap between what the screening is supposed to trigger and what actually happens to a resident afterward has been documented repeatedly over the past two decades.
At Miletree Center, inspectors did not document that any specific resident suffered harm as a result of the screening failure. But the structure of the PASARR requirement exists precisely because the harm from getting it wrong tends to be invisible and slow. A resident with an unaddressed mental illness who is placed in a general nursing population without appropriate psychiatric support doesn't necessarily show up in an incident report. The harm accumulates quietly, in daily discomfort, in untreated symptoms, in care plans that don't reflect who that person actually is.
The facility has said it corrected the problem. Whether that correction holds, and whether it addresses the underlying process that allowed the screening gap to occur in the first place, is something only a follow-up inspection will reveal.
What the August visit documented is that at least one resident at Miletree Center moved through the admission process without the mental health and intellectual disability screening that was supposed to happen. That resident's name does not appear in the inspection record. Their diagnosis does not appear. What they needed, and whether they got it, is not something the public record answers.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Miletree Center from 2025-08-18 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Corrections: We strive for accuracy in everything we publish. If you believe any fact in this article is incorrect, please contact us with details, and we will review and correct it promptly.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: October 28, 2026 · Our methodology
MILETREE CENTER in SPENCER, WV was cited for violations during a health inspection on August 18, 2025.
Federal health inspectors visited Miletree Center on August 18, 2025, responding to a complaint.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.