Failure to Coordinate PASARR Assessments and Initiate Recommended Occupational Therapy
Penalty
Summary
The facility failed to coordinate assessments with the Pre-Admission Screening and Resident Review (PASARR) program as required, resulting in a resident not receiving recommended occupational therapy services. The resident, who was cognitively intact with a history of seizure disorder, quadriplegia, anxiety, and depression, had a PASARR Level 1 Screening indicating mental illness and developmental disability. The interdisciplinary team (IDT) meeting recommended occupational therapy to help the resident regain the ability to feed herself, a goal important to her. However, there was no care plan for PASARR services, and the occupational therapy was not initiated as recommended. Interviews revealed that the MDS Coordinator, who was new to the position, was unaware of the resident's status and did not know why occupational therapy had not started. The Rehabilitation Director stated that an initial request for occupational therapy was denied, and a subsequent request was delayed because the physician was unavailable to sign it. The DON confirmed that the request should have been signed upon the physician's return but was not, and the MDS Coordinator was responsible for sending the request. Facility policy required initiation of specialized services within 20 business days of the IDT meeting and documentation within 3 business days, but these steps were not followed.