Q. How do you manage the ABN notice when a resident refuses therapy for three days?
A. CMS has clarified that an Expedited Review notice is not required when Medicare ends due to therapy refusals. If the resident is going to remain in the facility, give them the SNFABN (or Denial Letter), whichever you are using. This only needs to be given on or before the last covered day of Medicare. When a resident is refusing therapy, don’t forget to discuss and evaluate the reason for refusal. It’s important to be sure that the resident elects to end Medicare and that the refusals are not because we didn’t accommodate their choice for therapy scheduling. (Reference: www.aanac.org)