Failure to Coordinate PASRR Assessments and Provide Recommended Specialized Equipment
Penalty
Summary
The facility failed to coordinate assessments and implement recommendations from the Pre-Admission Screening and Resident Review (PASRR) program for a resident with multiple complex diagnoses, including cerebral palsy, schizoaffective disorder, chronic osteomyelitis, and lymphedema. The resident was identified as PASRR positive and required specialized services, including a customized manual wheelchair (CMWC), as recommended and agreed upon by the interdisciplinary team (IDT). Despite these recommendations, the facility did not provide or arrange for the CMWC within the required timeframe set by PASRR. Record reviews showed that the IDT meetings identified the need for several specialized assessments and services, including occupational therapy (OT), physical therapy (PT), speech therapy (ST), habilitation coordination, and independent living skills training. Documentation indicated that the facility was aware of the PASRR requirements and the need to submit the necessary forms and obtain physician signatures. However, delays occurred due to changes in the resident's payor source, frequent hospitalizations, and the unavailability of the medical director to sign required forms. As a result, the necessary PASRR forms and service arrangements were not completed in a timely manner. Observations confirmed that the resident continued to use a standard wheelchair rather than the recommended CMWC. Interviews with facility staff, including the MDS Nurse, Business Office Manager, and Administrator, revealed awareness of the outstanding PASRR requirements and the reasons for the delays, such as administrative transitions and lack of physician availability. Facility policy required timely notification and implementation of PASRR recommendations, but these procedures were not followed, resulting in the deficiency.