Failure to Complete Required PASARR Rescreens for Residents with Mental Health Diagnoses
Penalty
Summary
The facility failed to ensure that required Pre-admission Screening and Resident Review (PASARR) rescreens were completed for two residents with significant mental health histories or new mental health diagnoses. For one resident admitted with a history of chronic psychiatric illness, including bipolar disorder and executive deficits, the initial PASARR Level 1 screen did not identify a need for a Level II review. However, the clinical record and psychiatric notes documented a long-standing history of serious mental illness and the use of antipsychotic medication. Despite this, there was no documentation of a PASARR rescreen being initiated or completed after admission. The Social Work Director was unaware of the full extent of the resident's psychiatric history and did not initiate the required rescreen, as the psychiatric provider and facility staff did not communicate the relevant information to her. Another resident was admitted with diagnoses including anxiety disorder, dysthymic disorder, and PTSD. The initial PASARR Level 1 screen indicated no evidence of a PASARR condition, and no Level II was required at that time. Subsequently, the resident was diagnosed with major depressive disorder, a new mental health diagnosis. The clinical record did not show that a new PASARR Level 1 screen was submitted following this diagnosis. The Social Work Director confirmed that she was not the assigned social worker at the time of the new diagnosis and was unaware that a rescreen had not been completed, but acknowledged that a new PASARR should have been submitted upon identification of the new mental health condition. Facility policy requires coordination with the PASARR program to ensure that residents with mental disorders or related conditions receive appropriate care and services, including prompt referral for Level II review when a new or previously unidentified serious mental disorder is evident. The policy also assigns responsibility to the social services director for tracking PASARR screening status and making necessary referrals. In both cases, the facility did not follow its own policy, resulting in a failure to complete required PASARR rescreens for residents with significant or newly identified mental health conditions.