The September 19 admission violated federal regulations requiring Pre-admission Screening and Resident Review, known as PASRR, which screens for mental disorders and intellectual disabilities before nursing home placement. The resident also had epilepsy and moderate cognitive impairment, and would reject care from staff.
Staff C, the facility's admissions coordinator, told inspectors during an October 31 interview that they had a process to ensure each resident's documents included PASRR screening before admission. But they could not find any PASRR documents for this resident's admission.
"I thought we had one, but did not and I missed it," the coordinator said.
The facility's own policies required the screening. A policy titled "Admissions 1.08" from August 2025 stated that a PASRR Level 1 form would be completed prior to a resident's admission. Another policy from August 2024 specifically for residential habilitation center admissions required the facility to ensure the Level 1 PASRR was complete and accurate before admission for nursing facility services.
The resident's September 19 comprehensive assessment documented diagnoses including moderate intellectual disability, autistic disorder, and epilepsy. The assessment noted the resident had moderate cognitive impairment and behavioral challenges with rejecting care from staff.
PASRR screenings are designed to identify residents who may need specialized mental health interventions or services. Without the screening, residents face risks of receiving inadequate mental health care, increased behavioral problems, and diminished quality of life.
The facility administrator acknowledged the failure when informed on October 31 at 2:45 PM.
Federal regulations require nursing facilities to coordinate assessments with the pre-admission screening program and refer residents for services as needed. The screening process helps ensure residents with mental illness or intellectual disabilities receive appropriate care in the most suitable setting.
Moderate intellectual disability involves limitations on intelligence, learning, and everyday abilities necessary for independent living. Autistic disorder affects brain development and impacts how a person perceives and socializes with others. Epilepsy causes repeated episodes of sudden, brief changes in the brain's electrical activity.
The combination of these conditions, along with the resident's tendency to reject care, made the pre-admission screening particularly important for identifying appropriate interventions and support services.
Inspectors classified the violation as causing minimal harm or potential for actual harm, affecting few residents. The November 3 complaint inspection found the facility failed to ensure PASRR completion for one of three sampled residents reviewed for the screening requirement.
The missing screening represented a breakdown in the facility's admission process despite having written policies requiring the documentation. The admissions coordinator's acknowledgment that they "missed it" suggests the failure was due to inadequate oversight of admission requirements rather than a systematic problem with all admissions.
Without proper pre-admission screening, facilities cannot adequately prepare for residents' specific mental health and behavioral needs. This can lead to inappropriate care plans, insufficient staffing for behavioral challenges, and placement in settings that may not be equipped to handle complex conditions.
The resident's documented tendency to reject care from staff highlights why the screening process matters. PASRR evaluations can identify specific behavioral interventions, environmental modifications, or specialized services that help residents with intellectual disabilities and autism receive appropriate care.
Yakima Valley School must now implement corrective measures to ensure all future admissions include completed PASRR screenings before residents arrive. The facility's failure to follow its own admission policies put this vulnerable resident at risk for receiving care that might not address their complex mental health and developmental needs.
The administrator's acknowledgment of the violation suggests the facility recognizes the seriousness of admitting residents without completing federally mandated screenings designed to protect some of the most vulnerable people in institutional care.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Yakima Valley School from 2025-11-03 including all violations, facility responses, and corrective action plans.