Failure to Update PASARR After New Mental Health Diagnosis
Penalty
Summary
The facility failed to ensure that a PASARR Level 1 screening was completed after a new mental health diagnosis was identified for a resident. Initially, the resident had a primary diagnosis of cerebrovascular accident and a secondary diagnosis of dementia without behaviors. Subsequent behavioral notes documented significant changes, including verbal aggression, resistance to care, and delusional statements. The resident was later prescribed Seroquel for delusional disorders, and the medical record reflected additional diagnoses such as psychotic disorder, anxiety, depression, pseudobulbar effect, and non-Alzheimer's dementia. Despite these new symptoms and diagnoses, the PASARR Level 1 was not updated to reflect the resident's delusional disorder. The Director of Nursing (DON) confirmed that the new diagnosis was not included on the PASARR, stating that delusions were considered a symptom of dementia and therefore did not warrant a new screening. The DON also indicated that the facility's process did not involve completing a new PASARR when a new mental health diagnosis was added by a physician.