Failure to Provide Timely and Accurate Medicare Coverage Notices
Penalty
Summary
The facility failed to provide timely and accurate Notice of Medicare Non-Coverage (NOMNC) and Skilled Nursing Facility Advanced Beneficiary Notice (SNF ABN) to two residents. For one resident, the NOMNC indicated the last covered day under Medicare A would be 4/16/25, but the notice was signed only one day prior, on 4/15/25, not meeting the required advance notice period. The corresponding SNF ABN was also signed on 4/15/25, stating that private billing would begin on 4/18/25. For another resident, the NOMNC showed the last covered day as 2/19/25, but the form was signed and dated on the same day, again failing to provide the required notice period. During an interview, the social worker responsible for issuing these notices confirmed her responsibility and usual practice of providing three days' notice, but could not explain why the notices for these two residents were issued late and inaccurately.