Failure to Provide and Document Advanced Beneficiary Notice of Noncoverage
Penalty
Summary
The facility failed to provide the required Advanced Beneficiary Notice of Noncoverage (ABN) to a resident or their representative prior to the end of Medicare Part A coverage. Documentation reviewed for one resident showed that the last day of covered services was recorded, but there was no evidence that the ABN was given. The Business Office Manager was unable to locate any documentation of the ABN and stated that, since the resident was unable to sign, the representative would have been contacted by phone or mail. However, the Business Office Manager was unaware of the process for documenting such contact, and there was no record of a phone call or letter being sent. The Director of Nursing confirmed that documentation should exist if a phone call or letter was made or sent to the representative.