Delayed Submission of PASARR Specialized Services Request
Penalty
Summary
The facility failed to submit a completed and accurate request for nursing facility specialized services (NFSS) in the LTC Online Portal within 20 business days from the Interdisciplinary Team (IDT) meeting for a resident with mild intellectual disabilities, diabetes, hypertension, chronic kidney disease stage 5, and a history of stroke. The resident was admitted with a care plan that included interventions such as physical therapy due to poor balance and an unrealistic sense of physical abilities. Despite recommendations from the PASARR evaluation for physical and occupational therapy, the required NFSS forms were submitted late and contained errors, resulting in repeated rejections and a final submission marked as late according to PASARR timelines. Interviews with facility staff, including the MDS-RN, DON, and ADM, confirmed that the MDS-RN was responsible for handling the PASARR process and that the failure to submit accurate and timely forms led to a delay in the resident receiving Medicaid Entitled Services, specifically physical and occupational therapy. Record review showed that the NFSS form was denied due to an incorrectly completed signature page, and the facility's policy did not specify a timeline for submission from the IDT meeting. This deficiency resulted in the resident not receiving the recommended specialized services in a timely manner.