Failure to Provide Timely Medicare Non-Coverage Notices Before End of Skilled Nursing Care
Penalty
Summary
The facility failed to provide the required 48-hour advance notice of Medicare non-coverage and potential financial liability to two residents prior to the end of their Skilled Nursing Care stays. For one resident, documentation showed that Skilled Nursing Care began on 2/28/25 and transitioned to private pay on 3/20/25, but there was no evidence in the electronic health record or progress notes that the Notice of Medicare Non-Coverage (NOMNC) and Skilled Nursing Facility Advance Beneficiary Notice of Non-coverage (SNFABN) forms were reviewed with the resident or their Power of Attorney at least 48 hours before the transition. The forms were not signed until 10 days after the transition. For the second resident, Skilled Nursing Care started on 12/1/24 and transitioned to private pay on 1/14/25, but again, there was no documentation that the required notices were provided 48 hours in advance, and the forms were not signed until the day after the transition. Staff interviews confirmed that the process for providing these notices was not consistently followed. The Medical Records staff member stated that she spoke with the Power of Attorney before the resident was discharged from Skilled Nursing Care but admitted she may have forgotten to document it. The Nurse Manager indicated that a process exists to ensure the timely completion of Skilled Nursing Care notice forms, but the records reviewed did not reflect compliance with this process for the two residents in question.