A nursing facility must notify the state mental health authority or state intellectual disability authority promptly after a significant change in the mental or physical condition of a resident who has mental illness or intellectual disability for resident review. One commonly overlooked requirement is the facility's obligation to notify the appropriate state mental health or intellectual disability authority when a significant change in the resident's physical or mental status occurs.
Under F646, any resident with newly evident or possible serious mental disorder, ID or a related condition must be referred, by the facility to the appropriate state-designated mental health or intellectual disability authority for review. Examples of individuals who may not have previously been identified by PASARR to have MD, ID or a related condition include:
Surveyors may review facility processes to determine whether required PASARR notifications and referrals were completed timely and whether documentation supports compliance with state notification requirements. Facilities should ensure staff understand what constitutes a significant change and maintain documentation demonstrating when notifications were made and any resulting recommendations or determinations received from the state authority.