Failure to Timely Submit PASRR Specialized Services Documentation
Penalty
Summary
The facility failed to incorporate recommendations from the PASRR Level II determination and evaluation reports into the assessment, care planning, and transitions of care for two residents who were PASRR positive. For one resident with diagnoses including anxiety disorder, depression, schizophrenia, bipolar disorder, and unspecified intellectual disabilities, the facility did not submit the required Nursing Facility Specialized Services (NFSS) form within 20 business days following an interdisciplinary team (IDT) meeting. The resident's care plan identified the need for specialized services such as customized manual wheelchair, specialized therapy assessments, and habilitation services, all of which were accepted by the resident. However, documentation from the IDT meeting was not uploaded into the required portal in a timely manner, and the Director of Rehabilitation reported delays due to a system glitch and backlog in obtaining physician signatures. Another resident, diagnosed with cerebral palsy, scoliosis, and benign prostatic hyperplasia, also did not have the NFSS form submitted within the required timeframe after an IDT meeting where a customized wheelchair and therapy services were recommended. The Social Services Director was not fully aware of the resident's eligibility for specialized services and was only involved in making ancillary referrals. The Director of Rehabilitation acknowledged responsibility for submitting the NFSS forms and described technical issues with the portal that delayed submission. Despite these delays, the resident continued to receive therapy services, but the process for obtaining a customized wheelchair was delayed due to missed appointments with third-party vendors. Interviews with facility staff, including the Social Services Director, MDS Coordinator, and Administrator, confirmed that the Director of Rehabilitation was responsible for timely submission of required documentation. The facility's policy required NFSS forms to be submitted within 20 business days of the IDT meeting, but this was not consistently followed. The delays in documentation and submission of forms were attributed to technical issues with the portal and internal communication gaps, resulting in the failure to timely incorporate PASRR recommendations into resident care planning and service delivery.