Failure to Complete Required PASARR Screenings for Residents with Mental Illness
Penalty
Summary
The facility failed to ensure that required preadmission screening assessments (PASARR) were completed for residents identified with mental illness or intellectual disabilities. Specifically, four residents with diagnoses such as schizophrenia, schizoaffective disorder, and major depressive disorder did not have documentation of a completed Level I PASARR screening in their health records. These residents were admitted or readmitted to the facility over a range of years, and their diagnoses and medication orders, including antipsychotic prescriptions, were clearly documented in their records. Interviews with facility staff revealed confusion and lack of clarity regarding responsibility for completing PASARR screenings. The Business Office Manager/Admissions Director and the Social Services Director each described different understandings of their roles in the PASARR process, with both indicating that collaboration was supposed to occur, but in practice, there was a lack of coordination. Staff acknowledged that initial PASARR screenings had not been completed for the affected residents and were unsure why this had not occurred. In some cases, staff only became aware of the missing screenings after being prompted by surveyors or after contacting the state agency responsible for PASARR oversight. Facility policy requires that a Level I PASARR screen be completed for all potential admissions, regardless of payer source, to determine if the individual meets criteria for serious mental illness or intellectual disability. The policy also outlines procedures for referral to the state PASARR representative for Level II screening when indicated. Despite these policies, the required screenings were not completed for the identified residents, resulting in a failure to ensure that individuals with mental illness or intellectual disabilities received appropriate preadmission assessment.