Failure to Follow PASARR Level II Recommendations for Resident Discharge Planning
Penalty
Summary
The facility failed to follow the recommendations of an OBRA Level II Evaluation for one resident who was reviewed for PASARR compliance. The resident, who was admitted with diagnoses including Type II Diabetes, Depression, and Hypertension, was found to be cognitively intact and independent with transfers. The OBRA evaluation recommended that the facility's social work staff assist the resident in searching for a less restrictive setting, such as a senior apartment with home healthcare support, if the medical team agreed. However, there was no documentation in the resident's medical record indicating that these recommendations were addressed or followed up on. During an interview, the resident reported having asked social work about the possibility of discharge to a more independent living situation but felt their request was dismissed. The Director of Nursing acknowledged the lack of follow-up on the OBRA recommendations and stated that corporate staff would investigate further, but no additional information was provided by the end of the survey. The facility's policy requires that PASARR Level II recommendations be incorporated into the resident's assessment, care planning, and transitions of care, which was not done in this case.