cms_SC: 4898
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 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
4898 | PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINA- CLINTO | 425393 | 801 MUSGROVE STREET | CLINTON | SC | 29325 | 2016-05-25 | 156 | B | 0 | 1 | B82Q11 | Based on record review and interview, the facility failed to provide a detailed explanation of the reason coverage for services should not continue. Resident #27 was not issued the CMS- -DENC (Detailed Explanation of Non-Coverage) as required upon appeal for Medicare coverage. The findings included: During a review for issuance of liability notices on 5-25-16 at 12 PM, Resident #27 was noted to have been issued a CMS- -NOMNC (Notice of Medicare Non-Coverage) and a UR (Utilization Review) COMMITTEE DETERMINATION ON CONTINUED STAY letter on 4-6-16. At that time, Medicare non-coverage was appealed. There was no evidence that the detailed explanation about why coverage for services should not continue (CMS- -DENC) was issued to the beneficiary. While conducting the review, Social Services stated s/he was unaware that the Form CMS- -DENC should have been provided, | 2019-07-01 |