Eckerd Living Center: PASRR Screening Failures - NC
The social worker responsible for screening admissions told inspectors she didn't know residents with mental health diagnoses needed the evaluation unless they "demonstrated behaviors."
Resident #3 entered the facility in early 2024 with a bipolar disorder diagnosis. Federal law requires nursing homes to request Level II PASRR evaluations for residents with serious mental illness to ensure they receive proper treatment and determine if institutional care is appropriate.
The facility never made the request.
Instead, Resident #3 remained in the facility taking antipsychotic medication daily. By March 2026, the resident was receiving aripiprazole 7.5 milligrams at bedtime and bupropion 300 milligrams extended release, according to psychiatric progress notes.
The social worker, employed at Eckerd for five years, explained her misunderstanding during an April 8 interview. She said she checked the North Carolina PASRR website before Resident #3's admission on February 28, 2024, to verify the resident had the basic Level I screening completed in July 2022.
But she stopped there.
"She explained no request for a Level II PASRR evaluation was made when Resident #3 was admitted because the resident did not demonstrate behaviors," inspectors wrote. "She stated it was her understanding when a resident demonstrated behaviors, she needed to request an evaluation for Level II PASRR."
The resident's medical records told a different story. A physician ordered a psychiatric referral for antipsychotic medication management in April 2024. Mental health progress notes from May 2024 confirmed an active bipolar disorder diagnosis requiring ongoing psychiatric treatment.
The resident's comprehensive care plan, revised in April 2026, specifically addressed psychotropic medications related to bipolar disorder. The plan included monitoring for drug-related complications and adverse reactions.
Yet facility assessments repeatedly indicated Resident #3 was "not currently considered by the state Level II PASRR process to have serious mental illness." The resident continued taking antipsychotic medications "on a routine basis only," according to annual assessments.
The contradiction persisted for over two years. Resident #3 received psychiatric medication management from a mental health nurse practitioner while the facility maintained no specialized mental health evaluation was needed.
During the inspection, the social worker admitted she "was not aware an evaluation for a Level II PASRR was needed when a resident was admitted with a mental health diagnosis and had a Level I PASRR."
The administrator confirmed the facility's failure during an April 10 interview. No request was made for the Level II evaluation when Resident #3 was admitted with a mental health diagnosis, despite federal requirements.
"The Administrator stated going forward mental health diagnoses would be reviewed for newly admitted residents and if present a request would be made for a Level II PASRR evaluation," inspectors noted.
The PASRR system exists to prevent inappropriate institutionalization of people with mental illness and ensure they receive specialized services. Level II evaluations determine whether nursing home placement is appropriate or if community-based alternatives would better serve the resident's needs.
For Resident #3, that determination never happened. The facility collected the basic screening from 2022 and proceeded with admission and ongoing care without the comprehensive psychiatric evaluation federal law requires.
The resident spent more than two years in the facility under this arrangement. Daily antipsychotic medications continued. Psychiatric appointments occurred regularly. Care plans addressed mental health needs.
But the fundamental question of whether institutional placement was appropriate for someone with serious mental illness remained unanswered, buried in a social worker's misunderstanding of when federal screenings apply.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Eckerd Living Center from 2026-04-10 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 13, 2026 · Our methodology
Eckerd Living Center in Highlands, NC was cited for violations during a health inspection on April 10, 2026.
The facility never made the request.
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.
Frequently Asked Questions
- What happened at Eckerd Living Center?
- The facility never made the request.
- How serious are these violations?
- Violation severity varies from minor documentation issues to serious safety concerns. Review the inspection report for specific deficiency codes and scope. All violations must be corrected within required timeframes and are subject to follow-up verification inspections.
- What should families do?
- Families should: (1) Ask facility administration about specific corrective actions taken, (2) Request to see the follow-up inspection report verifying corrections, (3) Check if this represents a pattern by reviewing prior inspection reports, (4) Compare this facility's ratings with other nursing homes in Highlands, NC, (5) Report any new concerns directly to state authorities.
- Where can I see the full inspection report?
- The complete inspection report is available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request a copy directly from Eckerd Living Center or from the state Department of Health. The report includes specific deficiency codes, facility responses, and correction timelines. This facility's federal provider number is 345437.
- Has this facility had violations before?
- To check Eckerd Living Center's history, visit Medicare.gov's Care Compare and review their inspection history, quality ratings, and staffing levels. Look for patterns of repeated violations, especially in critical areas like abuse prevention, medication management, infection control, and resident safety.