Failure to Implement PASARR-Recommended Occupational Therapy Services
Penalty
Summary
The facility failed to coordinate assessments and care with the PASARR program by not incorporating the PASARR Level II recommendations for occupational therapy into a resident’s assessment, care planning, and transitions of care. The resident was an older female with autistic disorder, dementia, and a cognitive communication deficit, who required extensive to total assistance with all ADLs and had documented memory problems. Her care plan identified PASRR-positive status related to an intellectual disability and included an intervention for habilitative OT services five times per week for a defined period. A PASRR Comprehensive Service Plan meeting documented that the resident’s LAR accepted habilitation coordination and requested that the resident be re-evaluated for OT, with the PASRR form marking new specialized assessment and specialized OT services. Despite these PASARR determinations, the facility did not complete and submit the required NFSS request for OT through the Simple LTC portal within the 20-day timeframe following the PASARR IDT meeting. Portal records showed an OT assessment had been completed and was pending state review, but the necessary information was not entered in a timely manner. Interviews with the MDS coordinator, DOR, DON, and Administrator revealed that key staff either did not attend the PASARR IDT meeting, were unaware of the required timeframe, or believed the responsibility for portal submission rested with others. Staff acknowledged that, because the NFSS was not submitted within the required timeframe, the resident would not receive the PASARR-authorized OT services. The facility’s written policy stated it would coordinate assessments with the PASARR program to ensure individuals with mental disorders or intellectual disabilities received appropriate care and services, but this coordination did not occur for this resident’s OT services.
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