Failure to Refer Resident for PASRR Level II Re-evaluation
Penalty
Summary
The facility failed to refer a resident with an exempted hospital stay and a diagnosed mental disorder to the appropriate state-designated authority for a re-evaluation and determination. This deficiency was identified for one resident who was admitted with multiple diagnoses, including surgical aftercare, Alzheimer's disease with early onset, and Major Depressive Disorder. A BLTC Medicaid reviewer had documented a PASRR Level II 30-day exemption for rehabilitation, with instructions to submit the most current MDS, physician orders, social notes, and psychiatric information if the resident's stay exceeded 30 days. However, upon review, it was found that the facility did not document a PASRR Level I or resubmit the requested documents when the resident's admission exceeded 30 days. The Social Services Supervisor acknowledged awareness of the 30-day timeframe but had not sent the required documentation to BLTC.