cms_GA: 9449
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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 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
9449 | BAPTIST VILLAGE, INC. | 115615 | 2650 CARSWELL AVE | WAYCROSS | GA | 31502 | 2011-06-09 | 156 | D | 0 | 1 | RJCG11 | Based on staff interview, and review of the facility's "Skilled Nursing Facility Advance Beneficiary Notice" forms, it was determined that the facility failed to provide the estimated cost of continued services to three residents, who had been discharged from Medicare Part A services, in order to allow them to make an informed decision about whether or not they wanted to pay for the continuation of those services. Findings include: According to the CMS' instructions on the 70.4.3.5- "Providing Cost Estimations for Items or Services on the Form CMS- Skilled Nursing Facility Advance Beneficiary Notice (SNFABN)," estimated cost amounts could be provided either with the description of extended care items and services (i.e., in the "Items or Services" section) or on the "Estimated Cost" line. The facility believed that three residents were to be discharged from Medicare Part A services because they no longer required skilled rehabilitation and/or skilled nursing services. The facility had issued CMS form to those residents or authorized representatives on 12/08/10, 2/26/11, and 3/12/11. However, the facility failed to include the estimated cost for the continuation of the services for the three residents in order to allow them to make an informed decision about whether or not they wanted to pay for those services themselves. The facility's "Skilled Nursing Facility Advance Beneficiary Notice" forms (CMS ) for those three residents had no estimated cost and no contact information on the form. During an interview on 6/9/11 at 10:55 a.m., financial staff "OO" stated that the estimated cost (for the continuation of skilled services) was only filled out on the notice of discharge form for the Medicare Part B residents. She said that she had not ever provided that information to residents on the CMS forms. | 2015-07-01 |