Failure to Timely Incorporate PASARR Recommendations and Submit NFSS Request
Penalty
Summary
The facility failed to incorporate recommendations from the PASARR Level II determination and evaluation report into a resident's assessment, care planning, and transitions of care. Specifically, the facility did not submit a Nursing Facility Specialized Services (NFSS) request within 20 days of the Interdisciplinary Team (IDT) meeting for a resident with multiple mental health diagnoses, including schizoaffective disorder and major depressive disorder with psychotic features. The care plan identified the need for coordination with mental health services, but the required documentation and timely submission of the NFSS request were not completed as required. The delay was attributed to staff being unaware of the IDT meeting and confusion over responsibility for submitting the NFSS, resulting in the initial request being submitted late and subsequently denied before being resubmitted and accepted. Interviews with facility staff revealed lapses in communication and understanding of the PASARR process. The MDS nurse was on vacation during the IDT meeting and only learned of it later, while the Director of Rehabilitation was unaware of the meeting and did not know how to complete the NFSS form. The administrator acknowledged awareness of the issue but stated it occurred under previous administration. Facility policy requires timely coordination and documentation for PASARR services, but these steps were not followed, leading to a deficiency in ensuring the resident received the necessary specialized services in a timely manner.