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F0644
D

Failure to Update PASARR Assessment for Resident with New Mental Health Diagnoses

Buena Park, California Survey Completed on 06-05-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to coordinate an assessment with the Pre-Admission Screening and Resident Review (PASARR) program for a resident who had updated diagnoses of depression, schizoaffective disorder, bipolar disorder, and anxiety disorder. Upon admission, the PASARR Level I Screening incorrectly indicated that the resident did not have a serious diagnosed mental disorder and was not prescribed psychotropic medications for serious mental illness. However, subsequent medical record reviews and the Minimum Data Set (MDS) admission assessment documented active diagnoses of anxiety, depression, and schizophrenia, as well as the use of antipsychotic, antianxiety, and antidepressant medications. Despite these updated diagnoses and medication orders, the facility did not complete a new PASARR assessment to reflect the resident's current mental health status and treatment needs. The oversight was confirmed during an interview and medical record review with the MDS Assistant, who acknowledged that a new PASARR should have been completed when the resident's diagnoses and medications were updated in the medical record and MDS assessment.

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