Failure to Timely Implement PASRR Recommendations and Submit Required Documentation
Penalty
Summary
The facility failed to incorporate the recommendations from the PASRR Level II determination and evaluation report into a resident's assessment, care planning, and transitions of care. Specifically, after an Interdisciplinary Team (IDT) meeting determined that a resident required occupational therapy (OT) and physical therapy (PT), the required Nursing Facility Specialized Services (NFSS) request form was not submitted within the mandated 20 business days. As a result, the resident did not receive the recommended therapies for several months following the IDT meeting. Record reviews showed that the resident had diagnoses including Parkinson's disease and autistic disorder, with intact cognition and independence in most activities of daily living (ADLs), requiring only supervision for showers. The care plan was updated to reflect the need for specialized therapies, and the IDT meeting included relevant staff and the resident's responsible party. However, the PASRR Comprehensive Quarterly Service plan form was not provided, and the NFSS request was not submitted in a timely manner, delaying the initiation of therapy services. Interviews with facility staff revealed a lack of understanding and training regarding the NFSS process and the required documentation for PASRR services. The MDS Coordinator and Director of Therapy were unaware of the need to submit the NFSS forms, and the Director of Nursing did not follow up to ensure the paperwork was completed. The facility also lacked a policy or protocol for PASRR, contributing to the delay. Despite the delay, staff and the resident reported no decline in the resident's ADLs during the period in question.