Missing Medicare and Medicaid Benefit Posting
Summary
The facility failed to display information on how to apply for and use Medicare and Medicaid benefits and how to receive refunds for previous payments covered by those benefits on its required postings bulletin board. During an observation on 02/09/2026 at 3:15 PM, the required posting for Medicare and Medicaid benefits was not displayed in the bulletin board area that was observed. During interviews on 02/09/2026, the SW stated he was unsure where the required posting was located or whether it was posted, the DON stated she was unsure where it was located or whether it was posted, and the ADM stated it might be in the admissions office but was not made available to residents. The Admissions Director stated there was nothing posted in the facility regarding how to apply for and use Medicare and Medicaid benefits, although she was available to help residents if needed. On 02/10/2026, the ADM stated there was no specific facility policy on required postings and that the facility follows HHS and CMS guidelines.
Penalty
Resources
Below are regulatory guidelines relevant to this citation:
A resident with severe cognitive impairment was admitted with Medicare A, but the admission agreement stated the facility did not participate in Medicaid even though staff later said the facility did accept Medicaid residents and assisted families with Medicaid applications. The resident’s guardian said she did not apply for Medicaid because of the contract language.
Late NOMNC Delivery. A resident’s NOMNC for ending Medicare-covered skilled services was signed only 1 day before services ended, and the NHA confirmed it was not provided within the required 48-hour advance timeframe.
A facility failed to display required written information for residents and/or their responsible person on how to apply for Medicare and Medicaid benefits and how to receive refunds for previous payments covered by Medicare and Medicaid. Surveyors observed the missing information on the First Floor, Second Floor nursing unit, and Fourth Floor nursing unit, and the NHA confirmed the omission.
The facility failed to display written information on how to apply for Medicare and Medicaid benefits and how to receive refunds for previous payments covered by Medicare and Medicaid on two nursing units, including the [NAME] and Garden units. Surveyors observed the missing information, and the NHA later confirmed the deficiency.
Surveyors found that the facility did not display required written information in common posting areas, such as the lobby and hallways near nursing units, explaining how residents and their representatives can apply for and use Medicare and Medicaid benefits and obtain refunds for previous payments covered by those programs. During an interview, the NHA confirmed that this information was not posted anywhere in the building, resulting in noncompliance with state requirements for licensee responsibility and management.
The facility did not display required written information about how to apply for and use Medicare and Medicaid benefits, or how to receive refunds for previous payments covered by these benefits. This was confirmed during observations and an interview with the NHA.
Admission Contract Misstated Medicaid Participation
Penalty
Summary
The facility failed to provide an admission contract that accurately reflected its Medicaid participation status for one resident who was reviewed for admission contract issues. The resident was admitted with Medicare A as the payer source, and the quarterly MDS showed a BIMS score of zero out of 15, indicating severe cognitive impairment. The resident’s guardian stated she was given a contract at admission that said the facility did not accept Medicaid as payment, and she had not attempted to apply for Medicaid because of that contract. Record review of the resident’s admission agreement showed language stating that the resident may be considered a Medicaid beneficiary under applicable state law, but also stated, “The Facility does NOT participate in the Medicaid program.” During interviews, the BOM stated the facility did complete Medicaid applications with residents and family members and said the facility participated in Medicaid even though the contract said otherwise. The ADON and Administrator also stated the facility accepted Medicaid residents and were not sure why the contract was different.
Late Notice of Medicare Non-Coverage
Penalty
Summary
The facility failed to provide the Notice of Medicare Non-Coverage (NOMNC) within the required 2-day advance timeframe for one resident. Review of the resident’s medical record showed a NOMNC stating that Medicare-covered skilled services were ending on May 14, 2026, and the notice was signed and dated by the resident on May 13, 2026 at 9:00 a.m., which was only 1 day before the end of Medicare-covered services. During an interview on June 12, 2025 at 12:05 p.m., the Nursing Home Administrator confirmed that the NOMNC was not provided within the required 48-hour timeframe.
Missing Medicare and Medicaid Posting Information
Penalty
Summary
The facility failed to display written information for residents and/or their responsible person on how to apply for Medicare and Medicaid benefits and how to receive refunds for previous payments covered by Medicare and Medicaid in areas where postings were available, including the First Floor, Second Floor Nursing Unit, and Fourth Floor Nursing Unit. During observations on 4/7/26 from 12:51 p.m. through 1:10 p.m., surveyors found that the required information was not included on the postings in those locations. During an interview on 4/7/26 at 2:13 p.m., the Nursing Home Administrator confirmed that the facility had failed to display the required written information in the building.
Failure to Display Medicare and Medicaid Benefit Information
Penalty
Summary
The facility failed to display written information on how to apply for Medicare and Medicaid benefits and on receiving refunds for previous payments covered by Medicare and Medicaid on two of two nursing units, identified as the [NAME] and Garden nursing units. During observations on 3/4/25 at approximately 1:30 p.m., surveyors found that the required information was not included on either unit. During an interview on 3/6/26 at approximately 12:00 p.m., the Nursing Home Administrator confirmed that the facility failed to display the written information on applying for Medicare and Medicaid benefits and receiving refunds for previous payments covered by Medicare and Medicaid on both units.
Failure to Post Required Medicare/Medicaid Information for Residents
Penalty
Summary
The facility failed to display required written information for residents and/or their responsible persons on how to apply for and use Medicare and Medicaid benefits and how to receive refunds for previous payments covered by those benefits. During observations on 2/11/26 at approximately 11:30 a.m., surveyors inspected the first-floor lobby and hallways in and around the nursing units, where postings are typically available, and found that information on applying for Medicare and Medicaid and obtaining refunds for prior payments covered by these programs was not posted. In a subsequent interview on 2/12/26 at 9:00 a.m., the Nursing Home Administrator confirmed that the facility had not displayed this required written information anywhere in the building. The deficiency was cited under 28 Pa. Code: 201.14(a) Responsibility of licensee and 28 Pa. Code: 201.18(e) Management.
Failure to Display Medicare and Medicaid Benefit Information
Penalty
Summary
The facility failed to display written information for residents and their responsible persons regarding how to apply for and use Medicare and Medicaid benefits, as well as how to receive refunds for previous payments covered by these benefits. During observations conducted in the building, it was noted that this required information was not posted. Additionally, during an interview, the Nursing Home Administrator confirmed that the facility did not have the necessary written information displayed as required by regulations. No information was provided to residents or applicants for admission about these benefits or the refund process.
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