Failure to Complete Updated PASRR Referrals After New Psychiatric Diagnoses
Penalty
Summary
The facility failed to ensure that updated PASRR (Preadmission Screening and Resident Review) referrals were completed when new psychiatric diagnoses were identified after admission for three residents. For one resident, the initial PASRR Level I indicated no severe mental illness, intellectual disability, or related condition, but subsequent diagnoses of bipolar disorder, schizophrenia, and depression were added to the medical record. Despite an email request to complete a new PASRR referral and care plan documentation referencing chronic mental illness, no updated PASRR referral was submitted. Additionally, the care plan did not reflect the new diagnoses. For another resident, new diagnoses of unspecified dementia, major depressive disorder, and dementia in other diseases were entered after admission, but no updated PASRR referral or care plan interventions addressing these diagnoses were completed. A third resident received new diagnoses of major depressive disorder and generalized anxiety disorder, but these were not included in PASRR documentation, and no updated referral was made. Interviews with staff confirmed that the process for initiating PASRR referrals relies on notification of new diagnoses, but despite daily meetings and communication, no updated referrals were initiated for these residents.