Failure to Provide Required Medicare Discontinuation Notices
Penalty
Summary
Facility staff failed to provide proper notification of discontinued Medicare coverage to residents or their responsible parties, as required. During a review of Beneficiary Protection Notifications for three residents, it was found that two residents did not receive the required Skilled Nursing Facility Advance Beneficiary Notice (SNF ABN, CMS-10055) when their Medicare coverage was discontinued. Staff indicated on the review form that the ABN was not issued when it should have been. The Administrator confirmed in an interview that the notices were not provided due to the facility adjusting to new regulations. This deficiency was identified during a recertification and complaint survey, based on both document review and staff interview, and involved two out of three residents reviewed for beneficiary protection notifications.