A Family member is currently in a Skilled Nursing Facility (SNF) in NYC. On several occasions the nursing facility has told the family that their Medicare coverage is coming to an end and “Services” will end. Each time they had a meeting with the family this was presented as a discharge notice. However, nothing was received in writing. Of course, the first time the family panicked. Between Google, Medicare and AARP, they were advised to file an appeal. Upon contacting Livanta, the family was told the case was dropped by the nursing facility and that Livanta could do nothing for them. Approximately a couple of weeks later this repeated, again without a written discharge notice. This time, the Family filed an appeal with Livanta. The appeal was denied even after Livanta stated to the family that they had not received a copy of a discharge notice. Again, the family still believed that these were all verbal discharge notices. The last meeting was on Monday July 1st. Again, they were not given anything in writing. On July 2nd, the family was given a written one-page document stating that it was a termination of services, attached was a form to file another appeal this time with C2CInnovative solutions. There was no explanation of what services would be ending and the family did not ask, still believing this was a discharge notice. C2C rejected the appeal. The family has not received the hard copy as of this date. On July 4th the SNF would no longer give the patient physical therapy sessions. Medicare coverage runs out on July 20th.
It was after contacting the office of the NYC Ombudsman, on July 3rd , that they realized that what they had a notice of termination of services and not a discharge notice. Supposedly, this is a common practice of this SNF. if they had been issued a discharge notice they could have filed an appeal with the NYC Health Dept, which would halt any further action by the SNF, until a decision was reached. Since that is not the case, they can’t do anything?