Failure to Obtain Proper Signatures for Medicare Non-Coverage Notices
Penalty
Summary
The facility failed to provide evidence that the required Notification of Medicare Non-Coverage (NOMNC) and Skilled Nursing Facility Advance Beneficiary Notice of Non-coverage (SNF ABN) forms were issued and signed in a timely manner by the appropriate individual for one resident reviewed for beneficiary protection notification. Record review showed that the resident, who had severe cognitive impairment as indicated by a BIMS score of 06 and a physician determination of incapacity, signed the forms instead of the legal representative. The resident's emergency contact was listed as an Adult Protective Services (APS) worker and health care proxy. Staff interviews confirmed that the facility's process was to have the legal representative sign for residents lacking capacity, but in this case, the forms were signed by the resident due to an oversight.