Failure to Complete Required PASARR II Evaluation for Resident with Serious Mental Illness
Penalty
Summary
The facility failed to ensure that a Level II PASARR (Preadmission Screening and Resident Review) evaluation was completed for a resident with a known diagnosis of bipolar disorder, a serious mental illness. The resident was admitted to the facility following a hospital stay under a PASARR hospital exemption, which allowed for admission without a Level II PASARR on the condition that the resident would require less than 30 days of nursing facility services. The exemption documentation specified that if the plan changed and the resident required a longer stay, the OBRA Office should be notified for appropriate follow-up. Despite the resident becoming a long-term resident after multiple admissions, the facility did not initiate a Level II PASARR evaluation as required. The MDS nurse acknowledged that the resident should have had a PASARR II completed due to the extended stay but stated that the process had not been followed and the resident "fell through the cracks." The facility did not have a PASARR II on file for the resident at the time of the survey.