Failure to Refer for Level II PASRR After New Mental Disorder Diagnosis
Penalty
Summary
The facility failed to refer a resident for a Level II Preadmission Screening and Resident Review (PASRR) evaluation after a new mental disorder was identified. The resident was admitted with diagnoses of cerebral infarction and Parkinson's disease, and at admission, no mental disorder was present. The initial Level I PASRR screening indicated that a Level II evaluation was not required, but also stated that a new screening must be submitted if new information or changes occurred. Subsequently, an Advanced Practice Registered Nurse (APRN) documented a new diagnosis of psychotic disorder with delusions due to a known physiological condition. Despite this new diagnosis, the facility did not initiate a Level II PASRR evaluation. During interviews, the Director of Social Services confirmed that the process for identifying new mental disorders relied on psychiatry providers reporting new diagnoses to Social Services, who would then notify the appropriate agency for a Level II PASRR. However, in this case, the diagnosis was made by a medical APRN rather than a psychiatry provider, resulting in the process being missed. Additionally, the facility was unable to provide a policy for PASRR when requested.