Failure to Provide Timely Medicare Non-Coverage Notice
Penalty
Fine: $12,73529 days payment denial
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Summary
The facility failed to provide a resident with a written Notice of Medicare Non-Coverage (NOMNC) at least two calendar days before the end of Medicare Part A coverage. Record review showed that the NOMNC was issued to the resident's representative on the same day as the resident's discharge, which was one day after the last covered day. During an interview, the Social Services Director confirmed that the notification was not issued in a timely manner and acknowledged that neither the resident nor the representative was informed about the last Medicare covered day prior to discharge. Facility policy requires that the NOMNC be given in advance, no later than two days before the termination of services.