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F0582
D

Incomplete Medicare Non-Coverage Notice Provided to Resident

Mayfield Heights, Ohio Survey Completed on 05-29-2025

Penalty

Fine: $173,90029 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 a complete and accurate Notice of Medicare Non-Coverage (NOMNC) to a resident whose skilled services under Medicare A were ending. The resident, who had a history of heart disease, falls, and chronic obstructive pulmonary disease, remained in the facility after Medicare A services were discontinued. Review of the NOMNC signed by the resident showed that it did not specify the type of services being discontinued, nor did it include information on who to contact for an appeal or provide a phone number. This deficiency was confirmed during an interview with the President of Operations, who acknowledged the notice was incomplete.

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