Failure to Coordinate PASARR Assessments and Referrals for Mental Health Services
Penalty
Summary
The facility failed to coordinate assessments with the Pre-Admission Screening and Resident Review (PASARR) program and did not refer all residents with qualifying mental health diagnoses for appropriate services. Specifically, two residents with documented mental health conditions were not accurately identified on their PASARR Level One screenings, which were completed by an acute care hospital and subsequently uploaded by facility staff without correction. The Minimum Data Set Coordinator (MDSC) acknowledged that the PASARRs were submitted as received, even though the residents' medical records reflected diagnoses such as bipolar disorder, depression, anxiety, psychotic disorder, delusional disorder, and auditory hallucinations. For one resident, the MDS assessment and physician's orders indicated ongoing treatment for major depressive disorder, while the PASARR Level One screening incorrectly indicated no mental illness. For the second resident, the care plan and MDS assessment documented antipsychotic medication use and a history of auditory hallucinations, but the PASARR Level One screening also failed to reflect any mental illness. Interviews with facility staff, including the MDSC and DON, confirmed that the process for reviewing and correcting PASARR screenings was not consistently followed, and discrepancies between diagnoses and PASARR results were not always addressed. The facility's policy required that PASARRs be obtained, reviewed, and uploaded accurately and timely, with communication to local mental health authorities as needed. However, staff interviews revealed uncertainty and inconsistency in the process, with reliance on the information provided by referring hospitals and infrequent audits. As a result, residents with qualifying mental health diagnoses were at risk of not being referred for or receiving specialized services as required by the PASARR program.