Failure to Timely Resubmit PASARR After New Mental Health Diagnoses
Penalty
Summary
The facility failed to resubmit a Pre-admission Screening and Resident Review (PASARR) in a timely manner after a resident received new mental health diagnoses. According to facility policy, any resident with a significant change in mental health status, such as a new diagnosis, should be promptly referred to the state mental health or intellectual disability authority for additional review. In this case, a resident was admitted with diagnoses including hypertension and muscle weakness, and initially had a mild or situational depression diagnosis. On a later date, the resident was diagnosed with Post Traumatic Stress Disorder (PTSD) and Major Depressive Disorder, which were documented in the care plan and Minimum Data Set (MDS) assessment. Despite these new mental health diagnoses, the facility did not submit a new PASARR for the resident. The Medical Records LPN, who was responsible for making such referrals, confirmed during an interview that she failed to refer the resident to the state agency after the new conditions were identified. The Director of Nursing also confirmed that the facility's policy for PASARR referrals following new mental health diagnoses was not followed in this instance.