Failure to Timely Submit PASRR Specialized Services Request and Incorporate Recommendations
Penalty
Summary
The facility failed to coordinate assessments with the Preadmission Screening and Resident Review (PASRR) program as required, resulting in the omission of timely submission of the Nursing Facility Specialized Services (NFSS) request for a resident with multiple complex diagnoses, including aphasia, chronic kidney disease, muscle wasting, generalized weakness, dysphagia, malnutrition, anemia, and a history of cerebral infarction. The resident's PASRR Level II evaluation recommended specialized services such as physical therapy (PT), occupational therapy (OT), and speech therapy (ST), along with specialized assessments for each therapy. However, the facility did not submit a complete and accurate NFSS request in the LTC Online Portal within the required 20 business days after the Interdisciplinary Team (IDT) meeting, instead submitting it 217 days later. Interviews with facility staff revealed a lack of clarity regarding the required timeframe for NFSS submission, with the Director of Rehabilitation (DOR) acknowledging the importance of timely completion to maintain therapy services and the Administrator expressing uncertainty about the process. Record reviews confirmed that the recommendations from the PASRR evaluation were not incorporated into the resident's assessment, care planning, or transition of care as required, and duplicative testing and efforts were not avoided. This failure was cited under 26 TAC Chapter 554, Subchapter BB S554.2704(i)(7).