Failure to Provide SNF ABN to Residents Ending Medicare Part A Services
Penalty
Summary
The facility failed to provide a Skilled Nursing Facility Advanced Beneficiary Notice (SNF ABN) to residents whose Medicare Part A skilled services were ending, despite the facility's belief that continued services might not be covered by Medicare. For three residents reviewed, documentation showed that while a Notice of Medicare Non-Coverage (NOMNC) was discussed and signed, there was no evidence that a SNF ABN was reviewed with or provided to the residents prior to the end of their Medicare Part A coverage. Each resident remained in the facility after their skilled services ended, but their records lacked the required SNF ABN documentation. Interviews with the Business Office Manager revealed that the therapy team was responsible for reviewing the NOMNC with residents or their responsible parties and returning the signed forms to the business office. However, due to miscommunication between the therapy team and the business office, SNF ABNs were not being provided alongside the NOMNCs. The deficiency was confirmed by both the Business Office Manager and the Administrator, who acknowledged that the SNF ABN should have been issued to the residents prior to the end of their Medicare Part A skilled services.