Failure to Provide Required Medicare Non-Coverage Notice
Penalty
Summary
The facility failed to provide a required written Notice of Medicare Non-Coverage (NOMNC) to one resident receiving Medicare Part A services. Record review showed the resident was admitted on an unspecified date and had an End of Part A MDS assessment indicating the end date of the most recent Medicare Part A stay was 01/09/26. During an interview, the resident’s Power of Attorney stated she did not receive a NOMNC informing her of the last day of the resident’s Medicare Part A coverage. In a subsequent interview, the Administrator confirmed that staff did not give the resident or her POA a NOMNC, despite the facility’s expectation that residents or their representatives receive a copy of the NOMNC at least three to five days prior to the end of Medicare Part A coverage so they can make informed decisions regarding the resident’s care. The deficiency was identified through record review and interviews with the resident’s POA and the Administrator, and it involved one of three residents reviewed for beneficiary notices. The report notes that if residents or their representatives are not provided with the beneficiary notices, they may not make an informed decision about the services provided to them and this could likely result in a decline in health and function.
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