Failure to Refer Residents with New Serious Mental Illness Diagnoses for Required PASRR Level II Screening
Penalty
Summary
The facility failed to refer residents with newly diagnosed serious mental illnesses for required Pre-Admission Screening and Resident Review (PASRR) Level II assessments. Specifically, two residents were identified as having been diagnosed with schizophrenia after their initial PASRR Level I screenings, which had determined that no Level II review was necessary at the time. Despite these new diagnoses, the facility did not submit updated PASRR screenings as required by regulation and facility policy. For one resident, the face sheet documented a diagnosis of schizophrenia after the initial PASRR Level I screening, which had not identified a serious mental illness. The resident's care plan noted behaviors potentially related to mental health issues, including aggression and verbally inappropriate behaviors. Similarly, another resident was diagnosed with schizophrenia after their initial PASRR Level I screening, and was receiving antipsychotic medication. The care plan for this resident also referenced psychological conditions related to the new diagnosis. Interviews with facility staff revealed confusion and lack of clarity regarding responsibility for PASRR submissions and the process for handling new diagnoses of serious mental illness. Staff members provided inconsistent accounts of their roles and the requirements for resubmitting PASRR screenings when new mental health diagnoses are identified. Facility policy requires referral for Level II review upon significant change, such as a new diagnosis of serious mental illness, but this procedure was not followed for the two residents in question.