Failure to Provide SNF ABN Prior to Medicare Part A Discharge
Penalty
Summary
The facility failed to provide the required Centers for Medicare and Medicaid Services (CMS) Skilled Nursing Facility Advanced Beneficiary Notice (SNF ABN) to two residents prior to the termination of their Medicare Part A skilled services, as identified through record reviews and staff interviews. In both cases, the residents were given a Notice of Medicare Non-Coverage (NOMNC) indicating the end of their Medicare Part A coverage, but there was no evidence in their medical records that a SNF ABN was reviewed with or provided to them. Both residents remained in the facility after their Medicare Part A coverage ended. Interviews with facility staff revealed confusion and lack of clarity regarding responsibility for issuing the SNF ABN. The Business Office Manager and Social Worker each believed the other was responsible for providing the SNF ABN, and the Administrator was under the impression that the Social Worker handled all beneficiary notices. This miscommunication resulted in the SNF ABN not being issued to the affected residents, as required.