Failure to Provide Timely Notice of Medicare Non-Coverage
Penalty
Summary
The facility failed to provide the required Notice of Medicare Non-Coverage (NOMNC) to a resident whose Medicare-covered services were ending. According to the review, the NOMNC, which informs beneficiaries of the termination of Medicare coverage and their right to appeal, must be delivered at least two calendar days before the end of covered services. For the resident in question, there was no evidence that this notice was given within the required timeframe. Clinical documentation showed that the resident was admitted for Medicare A services and was making progress toward discharge, with plans for home health services upon leaving the facility. Despite clear indications in the record that discharge was anticipated, the facility did not provide documentation that the resident or their representative received the NOMNC two days prior to discharge, as required by regulation. This deficiency was confirmed through both record review and interview with the Nursing Home Administrator.