Failure to Provide Correct Medicare Part A Termination Notice
Penalty
Summary
The facility failed to provide the correct Medicare beneficiary notice to residents whose Medicare Part A therapy services were being discontinued. Specifically, three residents who had not exhausted their Medicare benefit days were issued the CMS-R-131 form, which is intended for Part B services, instead of the required Notice of Medicare Provider Non-Coverage (NOMNC), Form CMS-10123, which should be given at least three days prior to the end of Medicare Part A services. This omission was identified through record review and staff interviews, which confirmed that the incorrect form was used for a period of three months. The facility's policy requires that residents be given proper notice regarding the termination of Medicare Part A services, including information about the appeals process and the reason for discontinuation. However, the review found that the required NOMNC form was not provided to the affected residents, potentially impacting their ability to understand their rights and options regarding the discontinuation of skilled services. The error was attributed to a change in procedure during the administrator's absence, as reported by the staff responsible for issuing the notices.