Failure to Complete PASARR Rescreen After New Mental Health Diagnosis
Penalty
Summary
The facility failed to ensure that a Pre-admission Screening and Resident Review (PASARR) rescreen was completed for a resident following a new diagnosis of schizoaffective disorder. The resident had an initial Level 2 PASARR evaluation that determined they met the criteria for nursing home level-of-care but did not require specialized mental health services, and no further evaluations were required unless there was a change in condition related to mental illness. Despite the resident later being diagnosed with schizoaffective disorder, this significant change in mental health status was not reported or followed up with a new PASARR screening as required by facility policy and federal/state procedures. Review of the clinical record showed that the resident's primary diagnosis was updated to schizoaffective disorder, and the care plan included interventions for multiple mental health conditions, including the use of psychotropic medications. However, the annual MDS did not identify a serious mental illness or intellectual disability as a Level II PASARR condition. Interviews with facility staff confirmed that the only PASARR on file was the original one, and that a new Level 1 and potentially Level 2 PASARR should have been completed after the new diagnosis. The lack of timely PASARR rescreening following the change in mental health diagnosis constituted the deficiency.