Failure to Provide Required Medicare Non-Coverage Notice
Penalty
No penalty information released
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Summary
The facility failed to provide the required Skilled Nursing Facility Advanced Beneficiary Notice (SNFABN) of Non-coverage to a resident or the resident's representative when Medicare Part A coverage was discontinued, even though the resident's benefit days were not exhausted. The resident had returned from a qualifying hospital stay and began receiving Medicare covered services, but when the facility initiated discharge from Medicare coverage, there was no documentation that the SNFABN was given in advance as required. This was confirmed by the Business Office Manager, who acknowledged that the notice was not provided at the time Medicare services ended, despite the resident remaining in the facility for long-term care.