Failure to Provide ABN and Notice of Liability After Medicare Part A Discharge
Penalty
Summary
The facility failed to provide Advanced Beneficiary Notice (ABN) of non-coverage to residents whose Medicare Part A coverage was discontinued while they still had benefit days remaining. Specifically, two residents were discharged from Medicare Part A services but remained in the facility without being given notice of their financial liability for services not covered by Medicare after their coverage ended. Documentation review showed that both residents received a notice of non-coverage, but no ABN or notice of patient liability was provided. During an interview, the Business Office Manager responsible for these notices stated that she had misinterpreted the updated forms and had not been providing the required notice of potential liability to residents who remained in the facility after Medicare coverage ended.