Failure to Complete and Implement PASRR Requirements for Residents with SMI/ID
Penalty
Summary
The facility failed to ensure the accuracy and completion of the Preadmission Screening and Resident Review (PASRR) process for four residents with serious mental illness (SMI), intellectual disability (ID), or related conditions. For one resident, the PASRR Level I screening from the discharging facility did not indicate a diagnosis of SMI, despite the resident having a documented diagnosis of Depressive Schizoaffective Disorder. The facility did not have a process in place to verify the accuracy of PASRR documents received from other facilities, resulting in the omission of critical information. Another resident's PASRR Level I screening indicated the need for a Level II evaluation, but this was not completed because facility staff were unresponsive to multiple attempts by the state agency to schedule the evaluation. Similarly, a third resident required a Level II Mental Health Evaluation after a positive Level I screening, but the evaluation was not completed due to the facility's lack of response to the state's communication attempts. In both cases, the absence of follow-up and unclear staff responsibilities led to the closure of the cases without the required assessments being performed. For a fourth resident, the facility did not implement or follow up on specialized services recommended in the PASRR Level II Determination Report, such as psychotherapy, counseling, and neuropsychology consultation. There was no evidence that these recommendations were reviewed with the medical doctor or incorporated into the resident's care plan. Staff interviews confirmed that the recommended mental health services and consultations were not provided, and the facility's process for ensuring follow-up on PASRR recommendations was not followed.