Structure and implementation of comprehensive state preadmission screening programs for nursing home applicants: 1978-1994.

: This paper examines the structure and implementation of comprehensive state preadmission screening (PAS) programs for nursing home applicants from 1978 to 1994 in all 50 states and the District of Columbia. A state was considered to have comprehensive PAS if a majority of nursing home applicants were screened in-person by state or contract agency staff. Twenty-six states had implemented these programs by 1994, with the most growth taking place during the 1980s. The primary changes in program structure were an increased reliance on private providers to screen a subset of applicants and a higher percentage of states screening private pay applicants. All programs but one referred or authorized the use of community-based services, while most programs diverted well over 10 percent of nursing home applicants.