Failure to Refer Residents for Level II PASRR After New Mental Health Diagnoses
Penalty
Summary
The facility failed to refer two residents for a Level II Preadmission Screening and Resident Review (PASRR) after they were newly diagnosed with serious mental illnesses. One resident was admitted with diagnoses including bipolar depression, dementia, anxiety disorder, and frontotemporal neurocognitive disorder, and initially had a Level I PASRR. After being newly diagnosed with schizoaffective disorder, there was no evidence that a Level II PASRR referral was made. The social worker confirmed responsibility for such referrals and acknowledged that the required referral was not completed after the new diagnosis. The administrator and DON were unaware that a new Level II PASRR was needed following a new mental health diagnosis. Another resident was admitted with a Level I PASRR, and a previous Level II PASRR was halted as the resident did not meet criteria for mental illness at that time. Later, the resident was diagnosed with unspecified psychosis and prescribed an antipsychotic medication, but no new Level II PASRR referral was documented. The social worker believed the previous PASRR determination was indefinite and did not require further action, and the administrator and DON were not aware that a new referral was necessary after a secondary mental health diagnosis.