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F0582
D

Failure to Issue Required Beneficiary Notification Forms

Wichita, Kansas Survey Completed on 08-14-2025

Penalty

No penalty information released
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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 a completed Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN) form for one resident who transitioned from skilled nursing care to long-term care. The resident was admitted from the hospital for skilled nursing and rehabilitation services and later discharged from physical therapy to remain in the facility for long-term care. Although the Notification of Medicare Non-Coverage (NOMNC) form was signed, indicating the last covered day of service, the required SNF ABN form was missing from the resident's records. During an interview, administrative staff confirmed the absence of the SNF ABN and acknowledged that it should have been completed prior to the end of therapy services. The facility did not provide a policy regarding Beneficiary Protection Notifications.

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