Tweeten Lutheran: Medicare Notice Violations - MN
The resident, identified as R40 in the April 2 inspection report, had his Medicare Part A skilled nursing coverage terminated on March 4 when the facility decided to end his physical and occupational therapy services. His family never received the Notice of Medicare Non-Coverage form that would have informed them of their right to appeal the decision.
R40's physical therapist had determined he still needed standby assistance for all mobility and remained a fall risk. His occupational therapist concluded he required continued 24-hour care with family assistance for all activities of daily living. Both therapists recommended he continue using a front-wheeled walker for transfers.
Despite these ongoing care needs, the facility's business office failed to issue the legally required notice before discharge.
Progress notes show the facility made the decision to end R40's Medicare coverage on February 26, with his last covered physical therapy session on March 2 and occupational therapy on March 3. He was discharged home March 4 when his family arrived to pick him up.
The business office representative told inspectors the facility typically issues the Medicare non-coverage notice "a couple days before" when they know a resident's last covered date is approaching. But in R40's case, staff became confused about whether the notice was required since he was being discharged home.
"The facility did not issue the NOMNC due to R40 discharging home and there was confusion if the NOMNC need to be issued or not," the business office representative stated during a follow-up interview. The representative acknowledged the notice should have been provided.
R40's family member told inspectors during an April 1 interview that the resident was discharged "due to preference and funding reasons." The family member was unfamiliar with the Medicare non-coverage notice and asked whether such forms typically come from Medicare or the facility.
Most significantly, the family was unaware they had the option to appeal Medicare's decision to end coverage.
The inspection found the facility lacked a written policy governing when and how to issue Medicare non-coverage notices. When inspectors requested the policy, none was provided.
Federal regulations require nursing homes to provide advance notice when Medicare coverage will end, giving beneficiaries and their families the opportunity to appeal decisions they believe are incorrect. The notice must include specific information about appeal rights and procedures.
The violation affected what inspectors classified as "few" residents, though the report details only R40's case. Inspectors determined the harm level was "minimal" but noted the "potential for actual harm" when facilities fail to provide required beneficiary protections.
R40's discharge summary indicated his daughter understood he was a fall risk and would provide the recommended 24-hour care at home. The physical therapy discharge summary noted the therapist's decision to end services, while occupational therapy records emphasized his continued need for assistance with daily activities and mobility.
The facility's form CMS-20052 documented that R40's Medicare Part A services ended when benefit days were not exhausted, meaning coverage was terminated based on the facility's assessment rather than because he had used up his allotted Medicare days.
Without the required notice, R40's family lost the opportunity to challenge the facility's determination that skilled nursing services were no longer medically necessary. The appeal process could have potentially extended his Medicare coverage and allowed him to remain in the facility longer or receive additional covered services.
The inspection was completed April 2, with inspectors reviewing beneficiary notices for three residents total. R40 was the only resident whose required notices were not properly provided before Medicare coverage ended.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Tweeten Lutheran Health Care Center from 2026-04-02 including all violations, facility responses, and corrective action plans.
Additional Resources
- View all inspection reports for Tweeten Lutheran Health Care Center
- Browse all MN nursing home inspections
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 15, 2026 · Our methodology
Tweeten Lutheran Health Care Center in SPRING GROVE, MN was cited for violations during a health inspection on April 2, 2026.
His family never received the Notice of Medicare Non-Coverage form that would have informed them of their right to appeal the decision.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.
Frequently Asked Questions
- What happened at Tweeten Lutheran Health Care Center?
- His family never received the Notice of Medicare Non-Coverage form that would have informed them of their right to appeal the decision.
- How serious are these violations?
- Violation severity varies from minor documentation issues to serious safety concerns. Review the inspection report for specific deficiency codes and scope. All violations must be corrected within required timeframes and are subject to follow-up verification inspections.
- What should families do?
- Families should: (1) Ask facility administration about specific corrective actions taken, (2) Request to see the follow-up inspection report verifying corrections, (3) Check if this represents a pattern by reviewing prior inspection reports, (4) Compare this facility's ratings with other nursing homes in SPRING GROVE, MN, (5) Report any new concerns directly to state authorities.
- Where can I see the full inspection report?
- The complete inspection report is available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request a copy directly from Tweeten Lutheran Health Care Center or from the state Department of Health. The report includes specific deficiency codes, facility responses, and correction timelines. This facility's federal provider number is 245429.
- Has this facility had violations before?
- To check Tweeten Lutheran Health Care Center's history, visit Medicare.gov's Care Compare and review their inspection history, quality ratings, and staffing levels. Look for patterns of repeated violations, especially in critical areas like abuse prevention, medication management, infection control, and resident safety.