Failure to Provide Timely SNF ABN Forms to Residents
Penalty
Summary
The facility failed to provide timely Skilled Nursing Facility Advance Beneficiary Notice of Non-coverage (SNF ABN) forms to two of three reviewed residents. According to facility policy, residents must be given advance notice when Medicare Part A or Managed Skilled Care benefits will no longer cover their care and services. For one resident, the SNF ABN form was signed on the same day that services were set to end, rather than in advance as required. For another resident, there was no completed SNF ABN form found in the records, and staff confirmed that the notice had not been provided. Both residents had significant medical conditions, including coronary artery disease, high blood pressure, arthritis, heart failure, diabetes, and depression. The deficiency was identified through a review of facility documents, clinical records, and staff interviews, which confirmed that the facility did not adhere to its own policy or regulatory requirements regarding timely notification of non-coverage. This failure was cited under multiple state codes related to admission policy, licensee responsibility, management, and resident rights.