Failure to Refer Resident for PASRR Level II Evaluation After Exemption Expired
Penalty
Fine: $23,56582 days payment denial
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
A deficiency occurred when the facility failed to ensure that a resident with a specialized mental health diagnosis, specifically Post-Traumatic Stress Disorder, who was initially admitted under a 30-day convalescence categorical exemption, was properly referred for a PASRR Level II evaluation after their stay extended beyond the expected short-term period. Clinical record review showed that while the initial PASRR Level I was completed and the exemption applied, there was no evidence that the required referral to the State Mental Health Authority was made once the resident's status changed to long-term. This lapse was confirmed during an interview with the Area Manager of Clinical Reimbursement.