Failure to Provide Correct Medicare Beneficiary Liability Notice
Penalty
Summary
The facility failed to provide the correct Center for Medicare and Medicaid Services (CMS) Beneficiary Liability notice to three residents or their representatives when their skilled services ended. Specifically, instead of using the required Skilled Nursing Facility Advance Beneficiary Notice (SNFABN) form CMS 10055, staff provided the general Medicare Advance Beneficiary Notice (ABN) form CMS-R-131. This error was identified for three residents whose skilled services had ended on various dates, and the forms given did not include the necessary estimated costs for continued services, nor did they comply with the facility's own policy for Part A items and services. During interviews, an administrative nurse acknowledged not realizing the incorrect form had been provided to the families. The facility's policy, revised in August 2024, clearly stated that the SNFABN form CMS 10055 should be used for Part A services, but this was not followed in these cases. The failure to provide the correct notice could have impacted the residents' ability to make informed decisions regarding their skilled services.