cms_GA: 3199

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.

This data as json, copyable

rowid facility_name facility_id address city state zip inspection_date deficiency_tag scope_severity complaint standard eventid inspection_text filedate
3199 FOUNTAIN BLUE REHAB AND NURSING 115636 3051 WHITESIDE ROAD MACON GA 31216 2018-03-01 582 B 0 1 MRLK11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview, the facility failed to completely fill out the Skilled Nursing Facility Advance Beneficiary Notice (SNFABN) with the resident or responsible party's signature to indicate that they understood the contents of the form for two of three residents (R) reviewed (#34 and #46), who were discharged off Medicare Part A services. The sample size was 29 residents. Findings include: Review of a Beneficiary Notice-Residents discharged Within the Last Six Months form provided by the facility revealed that R #46 was discharged off Medicare Part A skilled services on 11/24/17 and remained in the facility afterwards with benefit days remaining. Further review of this form revealed that R #34 was discharged off skilled services on 12/26/17, and remained in the facility with benefit days remaining. Review of R #46's Annual Minimum Data Set ((MDS) dated [DATE] revealed a Brief Interview for Mental Status score of 5 (a BIMS score of 0 to 7 indicates severe cognitive impairment). Review of a Notice of Medicare Non-Coverage (NOMNC) form revealed his skilled services would end on 11/24/17, and the resident signed the form on that date which indicated he understood that he could appeal the decision to discharge him off skilled services. Review of his SNFABN form dated 11/20/17 revealed that Option 2 was checked, which indicated that the resident did not want to continue to receive skilled nursing services, Physical Therapy (PT), or Occupational Therapy (OT). Further review of this form revealed that there was no signature on the form of the patient or authorized representative. Review of R #34's Annual MDS dated [DATE] revealed that he had a BIMS score of 5. Review of a NOMNC revealed that his skilled services would end on 12/26/17, which he signed on the same day. Review of his SNFABN form dated 12/22/17 revealed that Option 2 was checked, but there was no signature on the form of the patient or authorized representative. During interview with the Business Office Manager (BOM) on 2/28/18 at 1:16 p.m., she stated that she took over doing the Medicare notices around 12/11/17 after the previous BOM left, and that she did not receive any formal training on how to complete the notices. She stated during further interview that she looked to see how the previous BOM filled out the forms, and that the previous BOM did not have either the resident or responsible party sign the SNFABN, so she continued to fill out the form the same way. She further stated that R #46's Medicare notices were obtained by the previous BOM, but that she completed R #34's notices. During continued interview, the BOM stated that she felt R #34's cognition was sufficient for him to understand the Medicare notices, and that when she explained the SNFABN to him he stated he understood he could appeal, and did not want to be charged to continue the skilled services. She further stated that she did not get him to sign the SNFABN, as that was not something the previous BOM did. During interview with the BOM on 2/28/18 at 1:34 p.m., she stated that the facility did not have a policy related to obtaining and filling out the Beneficiary Notices, but that they followed the Medicare guidelines on how to do this. Review of a facility-provided document titled Form Instructions Advance Beneficiary Notice of Noncoverage (ABN), OMB (Office of Management and Budget) Approval Number: 0938-0566 (undated) revealed: The ABN is a notice given to beneficiaries in Original Medicare to convey that Medicare is not likely to provide coverage in a specific case. The ABN must be reviewed with the beneficiary or his/her representative and any questions raised during that review must be answered before it is signed. Signature Box: Once the beneficiary reviews and understands the information contained in the ABN, the Signature Box is to be completed by the beneficiary (or representative). The beneficiary (or representative) must sign the notice to indicate that he or she has received the notice and understands its contents. Review of a CMS (Centers for Medicare and Medicaid Services) Medicare Learning Network document dated (MONTH) (YEAR) entitled Medicare Advance Written Notices of Noncoverage provided by the facility revealed: Completing an Advance Written Notice of Noncoverage: An advance written notice of noncoverage should be: Issued (preferably in person) to and comprehended by the Medicare beneficiary or his or her representative for the purpose of giving notice under applicable State or other law. Completed on the approved, standardized notice format, with all required blanks completed. Signed and dated by the beneficiary or his or her representative after he or she selects one option box. 2020-09-01