Failure to Provide Timely SNF Advance Beneficiary Notices
Penalty
Summary
The facility failed to provide timely Skilled Nursing Facility (SNF) Advance Beneficiary Notices (ABN) to residents and/or their representatives for two of three residents reviewed. For one resident, the last covered day of Medicare Part A skilled services was identified, and the facility initiated discharge from Medicare Part A services before benefit days were exhausted; however, the SNF ABN was not signed by the resident, and staff confirmed that the notice was not provided. For another resident, the spouse was notified of the SNF ABN by telephone only one day prior to the last covered day of Medicare Part A services, rather than the required two days in advance, as confirmed by staff interview. Review of the facility's policy on Advanced Beneficiary Notices indicated that notices should be provided at least two days before the end of a Medicare covered Part A stay to allow residents or their representatives sufficient time to make decisions regarding services and financial responsibility. The failure to provide timely and properly documented ABNs for these residents constituted noncompliance with both facility policy and regulatory requirements.