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F0582
D

Failure to Provide SNF ABN When Discontinuing Medicare Part A Services

San Jose, California Survey Completed on 06-27-2025

Penalty

No penalty information released
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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 a Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN) to two residents who were discharged from Medicare Part A services while still having benefit days remaining and continued to reside in the facility. For one resident, the medical record showed admission under Medicare Part A, with a planned discharge from these services while the resident remained in the facility. The facility's own documentation confirmed that the SNF ABN was not provided to this resident. Similarly, another resident was admitted under Medicare Part A, later discharged from these services with benefit days remaining, and continued to live in the facility without receiving the required SNF ABN. The interim social services director confirmed during an interview that the SNF ABN was not given to either resident. Facility records and CMS guidelines require that a SNF ABN be provided in such circumstances to inform residents of their financial liability and appeal rights when Medicare Part A services are discontinued. The failure to provide this notice was documented in the facility's records and confirmed by staff during the survey.

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