Failure to Provide Timely NOMNC
Penalty
Summary
The facility failed to provide a Notice of Medicare Non-Coverage (NOMNC) form in a timely manner for one resident. According to the facility's policy on Advance Beneficiary Notices, the NOMNC should be given at least two days before the end of Medicare coverage to allow the resident or their representative sufficient time to decide whether to continue services and assume financial responsibility. However, for Resident R76, who was admitted on 10/23/24 and had diagnoses including thyroid disorder, depression, and shortness of breath, the NOMNC was signed on the same day the services were set to end, 10/31/24. This was confirmed by the Social Service Director during an interview, indicating a failure to adhere to the policy of timely notification.
Plan Of Correction
NOMNC form notice could not be modified for R76 as resident has discharged from the building. Audit completed on like residents to ensure timeliness of provision of NOMNC were provided timely. Education on the timeliness of NOMNC will be provided to the social worker by the NHA or designee on or before 2/11/2025. All Audits will be conducted on NOMNC process by DON or designee weekly x 4 weeks and monthly x 1 month. Audit results will be reviewed through the monthly QAPI process/meeting.