Failure to Provide Timely Medicare Non-Coverage Notice
Penalty
Summary
The facility failed to provide timely notification to a resident or their representative regarding the end of Medicare coverage and the associated financial liability. Specifically, the Notice of Medicare Non-Coverage (NOMNC), which is required to be given at least 48 hours prior to the scheduled end of coverage, was not provided to the resident until after the services had already expired. Documentation reviewed by surveyors showed that the resident signed the notice after the expiration date of their Medicare services. During interviews, the Business Office Manager acknowledged that the notice should have been given two days before the end of coverage and confirmed that the resident was incorrectly billed for services after Medicare coverage ended. The facility's records indicated that the resident's account was adjusted to remove the charges, and the error was recognized by staff during the survey process. The deficiency was identified for one resident among those reviewed for liability notices.