Failure to Implement Required PASARR Specialized Services
Penalty
Summary
The facility failed to implement specialized services as required by the PASARR Level II outcome determination letter for a resident with significant mental health diagnoses, including schizoaffective bipolar type disorder, delusional disorder, panic disorder, auditory hallucinations, psychosis, suicidal ideations, depression, generalized anxiety, and insomnia. The PASARR determination approved the resident for nursing facility services with specific requirements for specialized behavioral health services, such as a crisis intervention plan, behavior management safety plan, ongoing psychiatric medication review, mental health counseling, and a behaviorally based treatment plan. Additional recommendations included self-health care management training, ADL training, therapy evaluations, skills training, adaptive equipment evaluation, and structured therapeutic activities. Medical record review and staff interviews confirmed that these required services were not implemented or documented in the resident's care plan after the PASARR determination was received. Staff, including the RN, clinical coordinator, and social service designee, verified that the specialized services had not been addressed or added to the care plan. The social service designee also indicated a lack of understanding that these services were mandatory per the PASARR determination letter, resulting in the resident not receiving the required supports.