Failure to Timely Submit PASARR Specialized Services Request for Resident Needing Custom Wheelchair
Penalty
Summary
The facility failed to coordinate assessments with the Pre-Admission Screening and Resident Review (PASARR) program as required, specifically by not submitting a request for Nursing Facility Specialized Services (NFSS) for a resident within the mandated 20 business day timeframe. The resident, who had cerebral palsy and was assessed as medically complex with intact cognition, was identified by the Local Intellectual and Developmental Disability Authority (LIDDA) as needing a customized DME wheelchair. Despite this recommendation being made during an interdisciplinary team (IDT) meeting, the facility did not submit the required NFSS request to the State Agency in a timely manner. Record reviews and interviews revealed that the social worker, responsible for submitting NFSS recommendations into the Texas Medicaid & Healthcare Partnership (TMHP) SimpleCFS website, did not complete the submission within the required period because the Director of Rehabilitation (DOR) had not secured the custom wheelchair from the vendor. The social worker was unaware of the 20-day submission requirement. Additionally, the facility's policy did not address the need to submit NFSS requests within this timeframe, as confirmed by the administrator. As a result, the resident did not receive the benefits of the LIDDA's recommendations in a timely manner.