Failure to Coordinate PASRR Assessment After New Mental Health Diagnosis
Penalty
Summary
The facility failed to coordinate assessments with the Pre-Admission Screening and Resident Review (PASRR) program for one resident who was reviewed for PASRR assessments. The resident, an older female with severe cognitive impairment and a BIMS score of 03, was admitted with active diagnoses of depression disorder and anxiety disorder. On a later date, she received a new diagnosis of schizophrenia, but the facility did not refer her to the appropriate state-designated mental health authority for review, nor was a new PASRR evaluation completed as required. The initial PASRR Level 1 screening did not indicate a mental illness, and the new diagnosis was not followed up with the necessary assessment. Interviews revealed that the DON was aware a new PASRR evaluation should have been completed after the new diagnosis, but the responsible MDS nurse was transitioning to another facility and did not follow up or inform others. The Regional MDS nurse was not aware of the new diagnosis until notified by the DON and confirmed that no new PASRR screening had been done. The facility administrator stated there was no specific PASRR policy in place, and the facility relied on state guidelines.