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F0582
D

Incomplete Beneficiary Notices for Two Residents

Torrance, California Survey Completed on 08-15-2025

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 accurately complete Skilled Nursing Facility Advance Beneficiary Notice of Non-coverage (SNF ABN) forms for two residents. For one resident with Alzheimer's disease, type 2 diabetes, dysphagia, and osteoarthritis, the SNF ABN form did not specify which services were being received or the cost per day for those services after Medicare Part A coverage ended. This resident required maximal assistance with activities of daily living and had moderately impaired cognitive skills. Similarly, another resident with anemia, type 2 diabetes, end stage renal disease, and congestive heart failure, who required partial assistance with activities of daily living and had intact cognitive skills, also had an incomplete SNF ABN form lacking details about specific services and daily costs. During an interview and record review, the admissions coordinator confirmed that the SNF ABN forms for both residents were incomplete, as they did not indicate the specific care areas or the cost per day for continued services. The facility's policy and procedure on beneficiary notice of non-coverage states that the SNF ABN is intended to inform residents about the services received and the potential out-of-pocket costs, allowing them to make informed decisions. The incomplete forms did not meet these requirements.

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