Inaccurate MDS Assessment for Resident with Schizophrenia
Penalty
Summary
The facility failed to ensure a complete and accurate Minimum Data Set (MDS) assessment for one resident. Resident 34, who was admitted with a diagnosis of Schizophrenia, had a PASRR Level 1 form indicating a mental health condition that could lead to a chronic disability, necessitating a PASRR Level 2 evaluation. The PASRR Level 2 evaluation confirmed the presence of a mental health condition and eligibility for mental health services. However, the resident's last comprehensive MDS assessment inaccurately stated that the resident was not considered by the state Level II PASRR process to have a serious mental illness or intellectual disability. This discrepancy was identified during a review of the resident's clinical record and confirmed by the Nursing Home Administrator and Director of Nursing.
Plan Of Correction
1. Resident 34's MDS was corrected. 2. Social services/designee completed an audit of residents with PASRR level 2 to verify Section A1500 is correct. 3. Social Service director was re-educated on completing accurate MDS assessments. 4. Social worker/designee will conduct random audits of PASRR level 2 residents to verify Section A1500 accuracy weekly x4 and monthly x3. Results of audits will be reviewed by the Quality Assurance Performance Improvement Committee and changes will be made as necessary.