Failure to Timely Issue SNF-ABN Prior to End of Medicare Coverage
Penalty
No penalty information released
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Summary
The facility failed to provide timely notification to a resident regarding the end of Medicare Part A coverage for skilled nursing services. The resident, who had been admitted with a diagnosis including spinal fusion, had their last day of covered Medicare Part A services on February 24, 2025. However, the required Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF-ABN) was not issued until February 25, 2025, after the coverage had already ended. This deficiency was confirmed through clinical record review and interviews with the Director of Social Services and the Nursing Home Administrator, both of whom acknowledged the delay in providing the required notice.