cms_GA: 3325
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 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
3325 | FORT VALLEY HEALTH AND REHAB | 115651 | 604 BLUEBIRD BOULEVARD | FORT VALLEY | GA | 31030 | 2019-08-08 | 582 | B | 0 | 1 | ZDTW11 | Based on record review and staff interview it was determined the facility failed to provide the Skilled Nursing Facility Advance Beneficiary Notice (SNF ABN- ) to two of three residents (R) (R#30 and R#41) reviewed that were discharged from Medicare Part A coverage. Findings included: A review of Form CMS- SNF Beneficiary Protection Notification Review was conducted on R#30 and R#41 that remained in the facility with skilled services discontinued. Review of records for R#30 revealed that skilled services were initiated on 4/25/19 with services ending 5/17/19. Review of documentation that was provided by the Business Office Manager (BOM) revealed no evidence that the SNF ABN CMS- form was provided to the resident by the facility. Review of records for R#41 revealed that skilled services were initiated on 1/24/19 with services ending 2/21/19. Review of documentation that was provided by the BOM revealed no evidence that the SNF ABN CMS- form was provided to the resident by the facility. An interview on 8/8/19 at 9:00 a.m. with the BOM. She confirmed that R#30 remains in the facility and was discharged from Physical Therapy, Occupational Therapy, Speech Therapy, and Skilled Nursing service on 5/17/19 and was not provided SNF ABN- . The BOM confirmed R#41 remains in the facility and was discharged from Physical Therapy, Occupational Therapy, and Skilled Nursing service on 6/13/19 and was not provided SNF ABN- . | 2020-09-01 |