Failure to Provide NOMNC to Resident's POA
Penalty
Summary
The facility failed to ensure that the Notice of Medicare Non-Coverage (NOMNC) was provided to and signed by the legally authorized Power of Attorney (POA) for a resident who had documented dementia and a legal POA with authority over insurance and government benefit decisions. Instead, the NOMNC was signed by the resident, whose signature did not match their legal name, and there was no documentation that the POA was informed of the notice or the associated appeal rights prior to discharge. The facility's process, as described by the Director of Social Services (DSS) and Social Services Coordinator (SSC), was to review the NOMNC with the POA and obtain their signature if the resident had a POA, but this was not followed in this case. Record review confirmed that the POA was listed as the resident's agent in the medical record and that the POA was not provided the NOMNC paperwork or informed of appeal rights before discharge. The POA stated in an interview that they were unaware of the appeal rights and would have considered appealing the discharge decision. The DSS acknowledged that the NOMNC was signed by the resident and not the POA, and there was no documentation of the notice being reviewed with the POA.