Failure to Refer Residents with Serious Mental Disorders for PASRR Screening
Penalty
Summary
The facility failed to refer residents with serious mental disorders to the state's mental health authority for Preadmission Screening and Resident Review (PASRR) assessments upon admission, as required. For one resident with a diagnosis of bipolar disorder, records showed no referral for PASRR screening at the time of admission, despite the resident being cognitively intact and receiving antipsychotic medication. Interviews with staff revealed confusion regarding the PASRR process, with the MDS nurse indicating that the resident's PASRR level was changed following the resident's request, and the administrator acknowledging the lack of documentation for a PASRR referral at admission. Another resident admitted with diagnoses including bipolar disorder and anxiety was also not referred for an updated PASRR screening upon admission. The PASRR Level I Determination Notification sent from the hospital did not indicate the need for a Level II screening, and the facility's financial counselor was unaware of the resident's mental health diagnosis requiring further screening. The MDS nurse stated she had not submitted a PASRR screen for this resident, waiting instead for previous medical records, and the administrator confirmed that an updated PASRR screening should have been completed at admission.