Failure to Complete Required PASARR Screening Prior to Admission
Penalty
Summary
The facility failed to ensure that each resident was properly screened for mental disorders or intellectual disabilities prior to admission, as required by policy and regulation. Specifically, for three residents reviewed, there was no documentation that a Preadmission Screening and Resident Review (PASARR) was completed by a qualified screener before their admission. The facility's policy mandates that all residents seeking admission must have a Level 1 PASARR screen completed by the referring agency or hospital, and if indicated, a referral for a Level 2 screen should be made to the appropriate agency. For one resident admitted with diagnoses including bipolar disorder, acute respiratory failure with hypoxia, and pneumonia, the PASARR form indicated 'No' for serious mental illness, despite the presence of a bipolar disorder diagnosis. There was no evidence that the PASARR was completed prior to admission. Another resident, admitted with morbid obesity, adjustment disorder with anxiety, and depression, also had a PASARR form indicating 'No' for serious mental illness, with no documentation that the screening was completed before admission. A third resident, admitted with depression, panic disorder, and multiple sclerosis, similarly lacked evidence of a completed PASARR prior to admission. Interviews with facility staff revealed that the social work department was responsible for reviewing PASARR forms before admission, and that the forms were typically completed by the referring hospital or agency. Staff acknowledged that discrepancies in dates could occur if residents were transferred between settings, and clarified that a diagnosis alone was not sufficient for a positive PASARR screen unless the mental illness was active or required inpatient treatment at the time. Despite these explanations, the required documentation of pre-admission screening was not present for the three residents in question.