Failure to Issue SNF-ABN Prior to End of Medicare Part A Services
Penalty
Summary
The facility failed to provide the required CMS-10055 Skilled Nursing Facility Advanced Beneficiary Notice (SNF-ABN) to a resident or their responsible party prior to the end of Medicare Part A skilled services, despite the resident having Medicare Part A days remaining. Record review showed that a Notice of Medicare Non-Coverage (NOMNC) was issued, informing the resident and responsible party of the end of Medicare Part A coverage for skilled services, but no SNF-ABN was given. The Social Service Director confirmed that the SNF-ABN was not issued and was unaware of the requirement to do so. The Administrator also acknowledged that the process for issuing the SNF-ABN was overlooked when the resident transitioned off Medicare Part A services.