Failure to Ensure Accurate PASRR Level I Assessments for Residents with Mental Illness
Penalty
Summary
The facility failed to ensure that Pre-admission Screening and Resident Review (PASRR) Level I assessments were accurate and updated for two residents with mental illness. For one resident, the electronic face sheet and care plan documented diagnoses including psychotic disorder with delusions, generalized anxiety disorder, and major depressive disorder, none of which were listed as the primary diagnosis of dementia. The resident's PASRR Level I form, however, indicated 'NO' for mental illness, and there was no evidence of a subsequent PASRR Level II evaluation or updated screening to reflect the resident's mental health diagnoses. Another resident had diagnoses including unspecified mood (affective) disorder, with no primary diagnosis of dementia. The resident's PASRR Level I form also indicated 'NO' for mental illness, and there was no documentation of an updated PASRR or Level II evaluation. Both residents were receiving psychiatric medications and had care plans addressing their mental health needs, but the PASRR documentation did not accurately reflect their diagnoses. Interviews with facility staff revealed that the MDS and PASRR coordinator relied on the PASRR forms received upon admission and did not compare them to the residents' current diagnoses. The coordinator was unaware that a new or existing diagnosis of mental illness required an updated PASRR, especially if dementia was not the primary diagnosis. The DON and administrator confirmed that PASRR forms should be reviewed for accuracy and updated as needed, but this was not consistently done. The facility's policy required review of PASRR forms for completion and correctness prior to admission, but this procedure was not followed in these cases.