cms_GA: 1978

In collaboration with The Seattle Times, Big Local News is providing full-text nursing home deficiencies from Centers for Medicare & Medicaid Services (CMS). These files contain the full narrative details of each nursing home deficiency cited regulators. The files include deficiencies from Standard Surveys (routine inspections) and from Complaint Surveys. Complete data begins January 2011 (although some earlier inspections do show up). Individual states are provides as CSV files. A very large (4.5GB) national file is also provided as a zipped archive. New data will be updated on a monthly basis. For additional documentation, please see the README.

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rowid facility_name facility_id address city state zip inspection_date deficiency_tag scope_severity complaint standard eventid inspection_text filedate
1978 ROSS MEMORIAL HEALTH CARE CTR 115515 1780 OLD HIGHWAY 41 KENNESAW GA 30152 2018-04-12 582 B 0 1 L5SJ11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility failed to provide the Advanced Beneficiary Notice (ABN) to five, Resident (R)#13, R#46, R#61, R#71 and R#175, of five records reviewed for those residents who were discharged from Medicare services with Medicare days remaining and remained in the facility. Findings include: 1. Review of the face sheet in the medical record for R#13 reveals the resident was admitted to the facility on [DATE] and currently resides in the facility. Review of facility records reveal R#13 was provided with a Notice of Medicare Non- Coverage (NOMNC) on [DATE] for services ending [DATE] with Medicare days remaining. This allowed her to an expedited review of a service termination if she chose to appeal the termination. This does not fulfill the facility's obligation to advise the resident of potential liability for payment. She remained in the facility for long term care services. R #13 was not provided with the ABN to inform her of the ending of skilled services that may not be paid for by Medicare so that she could assume financial responsibility if she wanted to continue those services. 2. Review of the face sheet in the medical record for R#46 reveals he was admitted to the facility on [DATE]. Review of facility records reveal R#46 was provided with a NOMNC on [DATE] for services ending on [DATE] with Medicare days remaining. This allowed him to an expedited review of a service termination if he chose to appeal the termination. This does not fulfill the facility's obligation to advise the resident of potential liability for payment. He remained in the facility for long term care services. R#46 was admitted to Hospice services on [DATE] and expired in the facility on [DATE]. R #46 was not provided with the ABN to inform him of the ending of skilled services that may not be paid for by Medicare so that he could assume financial responsibility if he wanted to continue those services. 3. Review of the face sheet in the medical record for R#61 reveals the resident was admitted to the facility on [DATE]. Review of facility records reveal R#61 was provided with a NOMNC on [DATE] for services ending on [DATE] with Medicare days remaining. This allowed her to an expedited review of a service termination if she chose to appeal the termination. This does not fulfill the facility's obligation to advise the resident of potential liability for payment. The resident remained in the facility for long term care services. R #61was not provided with the ABN to inform her of the ending of skilled services that may not be paid for by Medicare so that she could assume financial responsibility if she wanted to continue those services. R#61 was readmitted to Medicare services on [DATE] for additional therapy related to a recent fracture when weight bearing status was obtained from the physician. Review of facility records reveal R#61 was provided with a second NOMNC on [DATE] for services ending on [DATE] with Medicare days remaining. This allowed her to an expedited review of a service termination if she chose to appeal the termination. This does not fulfill the facility's obligation to advise the resident of potential liability for payment. R #61 remained in the facility for long term care services and was discharged to an Assisted Living Facility on [DATE]. R #61 was not provided with the ABN to inform her of the ending of skilled services that may not be paid for by Medicare so that she could assume financial responsibility if she wanted to continue those services. 4. Review of the face sheet in the medical record for R#71 reveals the resident was admitted to the facility on [DATE] and currently resides in the facility. Review of facility records reveal R#71 was provided with a NOMNC on [DATE] for services ending [DATE] with Medicare days remaining. This allowed her to an expedited review of a service termination if she chose to appeal the termination. This does not fulfill the facility's obligation to advise the resident of potential liability for payment. R #71 remained in the facility for long term care services. R #71 was not provided with the ABN to inform her of the ending of skilled services that may not be paid for by Medicare so that she could assume financial responsibility if she wanted to continue those services. 5. Review of the face sheet in the medical record for R#175 reveals the resident was admitted to the facility on [DATE]. Review of facility records reveal R#175 was provided with a NOMNC on [DATE] for services ending on [DATE]. This allowed her to an expedited review of a service termination if she chose to appeal the termination. This does not fulfill the facility's obligation to advise the resident of potential liability for payment. The resident remained in the facility for long term care services and was discharged from the facility on [DATE]. R #175 was not provided with the ABN to inform her of the ending of skilled services that may not be paid for by Medicare so that she could assume financial responsibility if she wanted to continue those services. On [DATE] at 4:00 p.m. in an interview in the conference room, with Employee DD who provides residents with the NOMNC and ABN, she stated she had provided each resident who remained in the facility with the NOMNC but had not given residents who remained in the facility with Medicare days remaining the ABN. Employee DD also stated verbally and in writing that she had not seen the ABN Form and was unaware it needed to be issued. She confirmed she had not provided this form to the five residents (R# 13, R#71, R#46, R#61 and R#175) when their Medicare services were ended with Medicare days remaining and remained in the facility. On [DATE] at 10:30 a.m. during an interview with the Administrator in his office, he stated the facility did not have a policy addressing the ABN and NOMNC and when they should be issued to residents. The Administrator provided a copy of guidelines used by the business office when to issue the NOMNC. Review of these guidelines revealed the guidelines did not address the ABN and when it should be issued to residents. He confirmed the five residents (R# 13, R#71, R#46, R#61 and R#175), did not receive the ABN Form when their Medicare services were ended with Medicare days remaining and they remained in the facility. The facility did not provide R# 13, R#71, R#46, R#61 and R#175 with the ABN when they were discharged from Medicare services with Medicare coverage days remaining and chose to stay in the facility. 2020-09-01