Failure to Provide Required Medicare Non-Coverage Notices
Penalty
Summary
The facility failed to provide a resident, who was receiving Medicare Part A skilled services and had days remaining in their benefit period, with the required Skilled Nursing Facility Advanced Beneficiary Notice of Non-Coverage (CMS-10055) and Notice of Medicare Non-coverage (NOMNC, CMS-10123) prior to facility-initiated discharge from Medicare Part A services. Record review showed that the resident's skilled services episode began on 01/05/2025, with the last covered day on 02/03/2025, and the discharge from Medicare Part A was initiated by the facility before benefit days were exhausted. Documentation confirming that the required notices were provided to the resident was not found. An interview with the Clinical Reimbursement Specialist confirmed the absence of the completed forms for this resident.