Surveyor Guidance - Medicare SNF ABN

VHCA (3/20/09)

As outlined by the Centers for Medicare and Medicaid Services (CMS), skilled nursing facilities (SNFs) are required to issue a liability notice before extended care item(s) and/or service(s), are initiated, reduced or terminated and Medicare is not expected to pay.  SNFs may use either the SNF Advance Beneficiary Notice (SNFABN) or one of the five SNF denial letters.  Additional information and documents are available here.

In January, CMS issued two new memos to State Survey Agency Directors with clarifications and updated guidance related to ABN requirements.  While the specific intent and objective of CMS with respect to these memos is not readily apparent, there is very specific wording in the first memorandum that the clarification provided is effective as of the document’s January 9th date.   According to the January 23, 2009 memorandum, the new guidance is effective for surveyors as of March 31, 2009.  A file containing both memos  is available and we encourage nursing facility members to review these documents along with their current procedures with respect to the notification process.

VHCA staff members are currently working to obtain additional information related to guidance and clarification within the two documents and any likely impact on our members.  We will provide additional information as it becomes available.