Failure to Issue Required Medicare Beneficiary Protection Notices
Penalty
Summary
The facility failed to provide required Beneficiary Protection Notifications to residents who were discharged from Medicare Part A services but continued to reside in the facility for non-skilled care, despite having Medicare benefit days remaining. Specifically, for one resident, although a Notice of Medicare Non-Coverage (NOMNC) was signed and delivered via telephone to the resident's representative, there was no evidence that the NOMNC was subsequently mailed or otherwise delivered as required by facility policy. Additionally, the Skilled Nursing Facility Advance Beneficiary Notice (SNFABN), which should inform the resident or representative about potential financial liability for non-covered services, was not issued. For another resident, the facility's records did not show that either the NOMNC or SNFABN was provided before the end of Medicare Part A services, even though the resident remained in the facility and had not exhausted benefit days. Staff interviews confirmed a lack of awareness regarding the requirement to mail the NOMNC when not hand-delivered and an absence of documentation for both required notices for the second resident.