Failure to Provide Required SNF Beneficiary Notification for Medicare Services
Penalty
No penalty information released
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 the required Skilled Nursing Facility (SNF) Beneficiary Notification, Form CMS-10055, to one of three sampled residents who received Medicare Part A skilled services. During an interview, a staff member confirmed that the notification form was not completed when the resident was discharged from skilled care services and was unable to explain the omission. Review of facility records showed the resident's Medicare Part A skilled services began on 4/10/25 and ended on 5/12/25, but there was no evidence that the required notification form was provided to the resident.