Failure to Provide Required SNF ABN Notification for Discontinued Skilled Services
Penalty
Summary
The facility failed to provide required Skilled Nursing Facility Advance Beneficiary Notice (SNF ABN) CMS form 10055 to two residents when their skilled services were discontinued prior to exhausting their covered Medicare days, despite both residents receiving and signing the Notice of Medicare Non-Coverage (NOMNC). The SNF ABN would have informed the residents of their option to continue services at a private pay rate. Record reviews confirmed the absence of the SNF ABN forms for both residents, even though facility policy required this notification when a resident remains in the facility after skilled services end but before Medicare days are exhausted. Interviews with staff revealed a lack of awareness regarding the requirement to provide the SNF ABN in these circumstances. The MDS coordinator acknowledged not knowing that residents who remained in the facility after skilled services ended, but before exhausting their benefit period, needed to receive the SNF ABN. The administrator confirmed that the MDS coordinator was responsible for completing the SNF ABN forms and recognized that not providing them meant residents or families were not informed about the option to continue services privately or the associated costs.