**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview the facility failed to refer a resident with intellectual disability or related condition to the appropriate state-designated authority for a level II PASARR (preadmission screening and resident review) evaluation and determination for 1 of 1 residents sampled for PASARR. (Resident number 45) The findings include: Review of Resident number 45's electronic medical record revealed the resident was admitted to the facility on [DATE] with a diagnosis of Down Syndrome. Review of the level I PASARR screen completed by the current Director of Nursing (DON) on 4/8/2021 revealed on page 2- section B, the resident had a current diagnosis of intellectual disability, mild, moderate, severe, or profound. Section 2- page 3 of the PASARR level I revealed there was indication the resident has or may have had a disorder resulting in functional limitations in major life activities that would otherwise be appropriate for the resident's developmental age. Section IV- page 5 of the PASARR level I revealed the resident may not be admitted to a nursing facility. Use the PASARR level I and required documentation to request a level II PASARR because there is a diagnosis of or suspicion of intellectual disability. An interview was conducted with the DON on 3/16/2022 at 11:00 AM. She stated she completed resident number 45's level I PASARR and the resident should have had a level II evaluation. She stated the level I triggered for a level II, but the facility did not ensure a level II PASARR was completed for the resident.