Failure to Coordinate PASRR Assessments for Resident with Mental Illness
Penalty
Summary
The facility failed to coordinate assessments with the Pre-Admission Screening and Resident Review (PASRR) program for a resident admitted with multiple mental health diagnoses, including Psychotic Disorder with delusions, Major Depressive Disorder, and Anxiety Disorder. Upon admission, the resident's PASRR Level 1 screening did not reflect her mental illness diagnoses, as the MDS Nurse relied primarily on hospital records, which did not indicate mental illness or dementia. The MDS Nurse later acknowledged that she used poor judgment by not updating the PASRR to reflect the resident's mental health conditions, which would have triggered a Level 2 PASRR screening by the local mental health authority. The resident was admitted with moderate cognitive impairment and was receiving antipsychotic, antianxiety, and antidepressant medications. Despite being seen by a mental health counselor and psychiatric provider shortly after admission, the lack of a Level 2 PASRR referral meant that these services were not coordinated through the local authority as required. The DON confirmed that the resident's PASRR should have indicated her mental illness diagnoses upon admission and acknowledged the absence of a facility policy regarding PASRR services, relying instead on state guidelines.