Failure to Complete Required PASARR Level II Assessments for Residents with Serious Mental Illness
Penalty
Summary
The facility failed to ensure that two residents with diagnoses of serious mental illness received the required Level II Preadmission Screening and Resident Review (PASARR) assessments prior to admission. For one resident, records showed diagnoses of diabetes mellitus, paranoid schizophrenia, major depressive disorder, and anxiety. Despite a positive Level I PASARR screening and ongoing psychiatric needs, the resident's PASARR file was closed due to a duplicate entry, and no new Level I screening was submitted as required. Staff interviews confirmed that a new screening should have been completed due to the resident's mental health history. For the second resident, who had diagnoses including major depressive disorder, anxiety, and bipolar disorder, the admission and assessment records indicated a lack of capacity to make decisions and a need for substantial assistance with daily activities. The PASARR process was not properly followed, as the determination letter was misread and a Level II evaluation was not initiated. Multiple staff members, including the MDS nurse, RN supervisor, and DON, acknowledged that both residents required new Level I screenings and that the PASARR process was not completed according to policy and federal requirements.