cms_GA: 9226

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.

Data source: Big Local News · About: big-local-datasette

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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
9226	LILLIAN G CARTER HEALTH AND REHABILITATION	115550	225 HOSPITAL STREET	PLAINS	GA	31780	2011-02-09	156	B	0	1	1SFM11	Based on a review of the facility's "Notice of Medicare Provider Non-Coverage" form and "Skilled Nursing Facility Advanced Beneficiary Notice" form, it was determined that the facility failed to include the specific items or services that would be denied and the estimated cost for those services for two residents (#21 and #22) in order to allow them to make an informed decision about whether or not they wanted to continue to receive specific items or services, knowing that they might have to pay for those items or services themselves. Findings include: The standards for use by Skilled Nursing Facilities (SNF) in implementing the CMS- form as described in the "70-Form CMS- Skilled Nursing Facility Advance Beneficiary Notice", instructed the SNF to give the specific reason(s) why it expected Medicare to deny payment. The reason(s) cited were to be in understandable lay language and sufficiently specific to allow the resident to understand the basis for the expectation that Medicare would deny payment. Estimated cost amounts could be provided either with the description of extended care items and services or on the "estimated cost" line. The facility believed that two residents' (#21 and #22) continued stay in the facility would not be paid for by Medicare Part A. However, the " Skilled Nursing Facility Advance Beneficiary Notice" form (CMS- ) did not include the specific items or services that would not be covered by Medicare and an estimated cost for the continuation of those items or services. 1. The facility issued a "Skilled Nursing Facility Advance Beneficiary Notice" to resident #21 on 11/16/10. The facility documented on that form that the current skilled nursing facility services would end on 11/19/10. An authorized representative of the resident signed the form 11/17/10. However, the facility failed to complete that form to describe the specific items or services that were to have been discontinued and an estimated cost for the items or services. 2. The facility issued a "Skilled Nursing Facility Advance Beneficiary Notice" and the "Notice for Provider Non-Coverage" form to resident #22 on 11/9/10. The facility documented on that form that the current skilled nursing facility services would end on 11/12/10. However, neither form had been signed or dated by the resident or authorized representative. The facility failed to describe the specific items or services that were to have been discontinued and an estimated cost for the items or services.	2015-08-01