Failure to Provide Required SNF ABN Prior to Discontinuation of Medicare Services
Penalty
Summary
The facility failed to provide the required Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN, Form CMS-10055) to residents or their responsible parties prior to discontinuing Medicare Part A services, as observed in the cases of two residents. One resident was discharged from Physical and Occupational Therapy due to non-compliance or refusal to participate, despite having Medicare benefit days remaining. The Accounts Manager confirmed that the SNF ABN was not provided because she was unaware of the form or the requirement to send it before discontinuing skilled services. Similarly, another resident was discharged from Medicare Part A services when benefit days were still available, due to cognitive inability to participate in therapy. The Accounts Manager again confirmed that the SNF ABN was not sent to the resident or their responsible party, citing lack of awareness of the form and its required use prior to discharge from skilled services. Both residents remained in the facility after skilled services were discontinued.