Failure to Provide Notice of Medicare Non-Coverage at Discharge
Penalty
Summary
The facility failed to provide a Notice of Medicare Non-Coverage (NOMNC) to a resident who was discharged from skilled nursing services under Medicare Part A. Clinical record review showed that the resident had a planned discharge to home and was cognitively intact, as indicated by a Brief Interview for Mental Status (BIMS) score of 15 out of 15. The resident was capable of independently understanding written instructions. However, there was no documentation of the required NOMNC being given to the resident at the time of discharge. Interviews revealed that the responsibility for completing beneficiary notification forms, including the NOMNC, had recently shifted from the business office to the social worker. The social worker, who had started a few weeks prior, did not complete the NOMNC for the resident due to a lack of training. The administrator confirmed the absence of a facility policy addressing beneficiary notification of non-coverage and acknowledged that the resident did not receive information on appeal rights as a result.