Failure to Update PASRR Assessment for Resident with New Mental Health Diagnoses
Penalty
Summary
The facility failed to coordinate assessments for a resident with newly identified or possible serious mental disorders. Review of the resident's Preadmission Screening and Resident Review (PASRR) showed no diagnosis or suspicion of serious mental illness or intellectual disability at the time of admission. However, subsequent documentation in the resident's admission record included diagnoses such as cognitive communication deficit, dementia with psychotic disturbance, delusional disorders, persistent mood disorders, recurrent major depressive disorder, and generalized anxiety disorder, with onset dates after the initial PASRR. Additionally, a physician order was present for Olanzapine to treat delusional disorders. Interviews with the Director of Nursing and the Regional Nurse Consultant confirmed that the PASRR was outdated and did not reflect the resident's current mental health status, and both indicated that a new PASRR should have been completed. Facility policy requires ongoing coordination with the state-designated authority and reassessment when a significant change in a resident's status occurs, which was not done in this case.