Failure to Notify CMS of Facility Name Change
Penalty
Summary
The facility failed to notify the Centers for Medicare & Medicaid Services (CMS) and obtain authorization for a change in the facility's name, as required by 42 CFR 424.516. The surveyor discovered this deficiency during a review of the facility's website and physical signage, which displayed the name "Shore Point Care Center" instead of the CMS-licensed name "Gateway Care Center." This discrepancy was confirmed upon arrival at the facility, where the surveyor observed the incorrect name on the building and on business cards provided by facility representatives. During interviews, facility representatives acknowledged that the facility had been operating under the name "Shore Point Care Center" for nearly three years, and they claimed that the state licensing department was aware of this. However, the facility was unable to provide documentation showing that the New Jersey Department of Health Division of Certificate of Need & Licensing or CMS had been notified of the name change. The facility's license, issued by the New Jersey Department of Health, still listed the name as "Gateway Care Center." Further investigation revealed that the facility had not completed the necessary CMS form 855B to report the name change. The facility representatives admitted that the name change was intended for marketing purposes and had not been formally processed with the appropriate regulatory bodies. As a result, the facility decided to revert to operating under the name "Gateway Care Center" and planned to change the signage back to reflect the licensed name.
Plan Of Correction
Element 1 This deficiency was corrected by revising the name listed on facility documents back to Gateway Care Center. Element 2 All residents have the potential to be affected by this deficiency. Element 3 Facility understands that in order to operate under a different name, the Department of Health Division of Certificate of Need must be notified, and the form 855B to CMS must be completed. Element 4 To maintain and monitor ongoing compliance, the Administrator will conduct a Facility Name audit to ensure documents are listed as Gateway Care Center. The Facility Name audit will be conducted by the Administrator or designee once a week for two months, then once every other week for two months, and then once a month for two months. Identified issues will be corrected as they are discovered, results will be reported to the Administrator and will be reviewed at quarterly QAPI meetings for six months to the Quality Assurance Performance Improvement team for review and action as necessary.