Failure to Complete Accurate PASRR Screenings and Referrals for Residents with Mental Health Diagnoses
Penalty
Summary
The facility failed to ensure that required Pre-admission Screening and Resident Review (PASRR) screenings were completed accurately and that referrals were made to the appropriate state-designated mental health or intellectual disability authority for two residents. For one resident, the initial PASRR Level I screening prior to admission was left mostly blank, and subsequent screenings failed to reflect new diagnoses of schizoaffective disorder, despite documentation in the clinical record and provider notes. The social services staff were not aware of the new diagnosis and did not complete the necessary 30-day review or submit a referral for a Level II PASRR, as required when a new mental health diagnosis is identified. Another resident had a history of multiple mental health diagnoses, including major depressive disorder, mood disorder, bipolar disorder, and anxiety disorder. Despite these diagnoses, the PASRR Level I screening completed years after admission indicated no serious mental illnesses and did not reflect the resident's active diagnoses. No evidence was found that a new PASRR was completed or that a referral was made for a Level II evaluation, even as the resident continued to receive psychotropic medications for these conditions. Interviews with facility staff, including social services and the MDS coordinator, confirmed that the PASRR screenings were not completed in accordance with policy and did not accurately reflect the residents' mental health status. Staff acknowledged that new diagnoses and changes in condition should have triggered new screenings and referrals, but these actions were not taken due to lack of communication and awareness of the residents' updated diagnoses.