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F0644
E

Failure to Refer for PASRR Reevaluation After Short-Term Approval Expired

Galesburg, Illinois Survey Completed on 07-02-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to notify the state mental health authority for reevaluation when the Preadmission Screening and Resident Review (PASRR) short-term approvals ended for six residents. According to the facility's policy, all applicants are to be screened for serious mental disorders or intellectual disabilities, and a PASRR Level II evaluation determines the need for specialized services and the appropriate setting. For each of the six residents, documentation showed that their short-term PASRR approvals had expired, but there was no evidence in their medical records that a referral for reevaluation was made or that the state mental health authority conducted a reevaluation after the approval period ended. This deficiency was confirmed through both interview and record review. The Social Services Director acknowledged that the affected residents were not reevaluated by the state mental health authority as required when their short-term PASRR approvals expired. The lack of timely referral and reevaluation was identified for each resident based on the expiration dates listed in their PASRR Level II Outcome Notices and the absence of corresponding documentation in their records.

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