Failure to Accurately Screen and Refer Residents for PASRR Level II Evaluation
Penalty
Summary
The facility failed to ensure that three of four sampled residents were properly screened and referred for Preadmission Screening and Resident Review (PASRR) Level II evaluations as required. For one resident with diagnoses including post-traumatic stress disorder, anxiety disorder, and depression, the PASRR Level I screening completed prior to admission did not accurately identify the presence of a serious mental illness, and no referral for a Level II evaluation was made. The Director of Nursing (DON) confirmed that the facility's process involved the Interdisciplinary Team (IDT) reviewing PASRRs upon admission, but in this case, the PASRR was not accurately completed or followed up. Another resident with diagnoses of psychotic disorder, anxiety, and depression also had a PASRR Level I that failed to accurately reflect their mental health conditions, and the DON acknowledged the screening was not accurate. A third resident, admitted with depression and schizophrenia, had a PASRR Level I that indicated the need for a Level II mental health evaluation and referral, but the resident was not rescreened or referred to the appropriate state mental authority. The facility's policy required designated staff to review PASRRs from acute hospitals and determine if follow-up, such as a Level II referral, was needed. These failures were identified through interviews and record reviews, and the DON confirmed the deficiencies in the PASRR screening and referral process for all three residents.