Failure to Timely Submit PASARR Specialized Services Requests
Penalty
Summary
The facility failed to incorporate recommendations from the PASARR Level II determination and evaluation report into a resident's assessment, care planning, and transitions of care. Specifically, the facility did not submit a complete and accurate request for nursing facility specialized services (NFSS) in the LTC Online Portal within 20 business days after the date of the Interdisciplinary Team (IDT) meeting, as required. Record review showed that a resident with Parkinson's disease and intellectual disabilities was admitted and had a care plan that included a specialized wheelchair and recommendations for occupational and physical therapy (OT/PT) through the PASARR program. The IDT meeting discussed initiating therapy services, and the NFSS forms were completed for both OT and PT referrals. However, the NFSS forms were initially submitted with the incorrect Authorization Type as 'new' instead of 'restart,' resulting in denial and the need for resubmission. The Director of Rehabilitation (DOR) was unaware of the requirement to submit the NFSS within 20 business days from the last IDT meeting. Interviews confirmed that the facility did not have a PASARR policy in place and relied on state regulations. This failure to timely and accurately process the PASARR-related service requests led to the deficiency identified during the survey.