Failure to Provide Required Medicare Non-Coverage Notice
Penalty
Summary
The facility failed to provide a Notice of Medicare Non-Coverage (NOMNC) to a resident whose Medicare Part A skilled services were ending. The resident, who was admitted for acute kidney failure and was moderately cognitively impaired, required substantial assistance with daily activities. According to the facility's records, the resident's last covered day for Medicare Part A services was documented, and the discharge was planned with the resident returning home with home health services. However, there was no evidence that the NOMNC was issued to the resident as required. During interviews and record reviews, both the Business Office Administrator and the Director of Nursing were unable to locate the NOMNC or determine if the discharge was beneficiary-initiated. The facility's policy required that a NOMNC be issued at least two calendar days before Medicare benefits end, but the documentation and staff interviews confirmed that this did not occur for the resident in question.