Failure to Issue Required Medicare Non-Coverage Notice Upon Discharge
Penalty
Summary
The facility failed to issue the required Center for Medicare/Medicaid Services (CMS) Notification of Medicare Non-Coverage Form 10123 (NOMNC) to a resident whose Medicare Part A episode began on 03/28/25 and ended on 04/16/25. The resident, who had met therapy goals and was discharged home, did not have documentation in the clinical record of receiving the NOMNC for this Medicare Part A episode. Interviews with Social Services and Administrative Nursing staff revealed that the facility did not provide NOMNC notices to residents discharged home with Medicare A days remaining, based on their understanding of the requirements. The facility's policy indicated a process for denial or end of benefits to inform residents and families, but this was not followed in the case reviewed.
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