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F0582
D

Failure to Provide Required Medicare Coverage Notices to Discharged Residents

Kalamazoo, Michigan Survey Completed on 06-04-2025

Penalty

Fine: $80,30015 days payment denial
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to provide required Skilled Nursing Facility-Advanced Beneficiary Notice of Non-coverage (SNF-ABN) and Notice of Medicare Non-coverage (NOMNC) forms to two residents prior to their discharge. Both residents had significant medical conditions, including metastatic lung cancer, COPD, malnutrition, and cognitive deficits. Review of records and interviews confirmed that these forms were not issued as required, and no documentation of the forms could be located for either resident. The Social Services Director, who became responsible for issuing these forms in mid-February, reported that she did not provide the SNF-ABN or NOMNC forms to the affected residents prior to their discharge. The Regional Director of Operations also confirmed that, due to a transition in social services leadership during the residents' stays, the required forms were not completed and could not be found. No copies of the SNF-ABN or NOMNC forms were provided to surveyors for either resident by the time of the survey exit.

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