cms_GA: 2709
Data source: Big Local News · About: big-local-datasette
rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
2709 | COUNTRYSIDE HEALTH CENTER | 115592 | 233 CARROLLTON STREET | BUCHANAN | GA | 30113 | 2018-01-05 | 582 | B | 0 | 1 | RXF711 | Based on record review and staff interview it was determined that the facility failed to provide Notice of Medicare Non-Coverage (NOMNC) to three (3) of three (3) selected residents; one resident (R#150) with a planned discharge and two residents (R#41) and (R#11) discharged from Medicare Part A Services, that chose to remain in the facility. Sample size was 30 residents. Facility census was 51 residents. Findings include: On 1/03/18 at 11:35 a.m. A review was conducted on three selected residents that received beneficiary protection notification from the facility. One resident (R#150) voluntarily discharged and two remained in the facility with services discontinued; residents (R#41) and (R#11). Review of records for R#41 indicates that services for physical therapy, occupational therapy and speech were initiated on 12/6/17 with services ending 12/31/17, date of Skilled Nursing Facility Advance Beneficiary Notice (SNFABN) was 12/27/17. No evidence was found that the Notice of Medicare Non-Coverage (NOMNC) (CMS ) form was provided to the resident by the facility. Review of records for R#11 indicates that services for physical therapy, occupational therapy and speech were initiated on 9/26/17 with services ending 11/24/17, date of Skilled Nursing Facility Advance Beneficiary Notice (SNFABN) was 11/21/17. No evidence was found that the Notice of Medicare Non-Coverage (NOMNC) (CMS ) form was provided to the resident by the facility. Review of records for R#150 indicates that services were initiated on 11/17/17 with services ending 11/30/17, date of Skilled Nursing Facility Advance Beneficiary Notice (SNFABN) was not found. No evidence was found that the Notice of Medicare Non-Coverage (NOMNC) (CMS ) form was provided to the resident by the facility. During an interview on 1/03/18 at 11:35 a.m. with the Social Services Director, she confirmed that she handles all the beneficiary notifications. She further stated the facility uses the SNFABN (CMS ) form only and that she has never given the NOMNC (CMS ) form to the residents. She stated that she thought that the SNFABN (CMS ) form was enough. An interview was conducted on 1/03/18 at 2:10 p.m. with the Social Services Director. At that time, she stated that she had just had a phone call with the facility corporate MDS Coordinator and he informed her that she should be providing both forms, the NOMNC (CMS ) form as well as the SNF ABN (CMS ) form to residents when services were ending. She confirmed she now understands the process and will make changes immediately. | 2020-09-01 |