Failure to Complete PASRR Referrals After New Mental Health Diagnoses
Penalty
Summary
The facility failed to ensure that new referrals for Pre-Admission Screening and Resident Review (PASRR) were completed when residents received new mental health diagnoses and started new psychotropic medications. For one resident, a PASRR Level I screening was initially completed documenting dementia and anxiety, but later, a new diagnosis of psychotic disorder with delusions was added, and an antipsychotic medication was prescribed. Despite these significant changes, a referral for a new PASRR review was not completed at the time of the new diagnosis and medication initiation, as confirmed by staff interviews and record review. For another resident, a transfer from another facility included diagnoses of dementia with psychotic disturbance and anxiety disorder, and a new diagnosis of delusional disorder was added after admission. The medical record showed a previous PASRR Level II screen that excluded the resident based on a primary neurocognitive disorder, but there was no evidence that a new PASRR referral was submitted after the new diagnosis of delusional disorder. Staff interviews confirmed a lack of awareness and action regarding the need for PASRR resubmission following the updated diagnosis.