Failure to Provide Timely Notice of Medicare Non-Coverage
Penalty
Summary
The facility failed to provide a timely Notice of Medicare Non-Coverage (NOMNC) (CMS-10123) to a resident receiving Medicare Part A skilled services. Record review showed the NOMNC for Resident #81 stated that coverage for current SNF services would end on 11/18/25, but the form was signed by both the resident and the resident’s representative on 11/17/25, not 48 hours prior to the end of covered services as required. Social Services documentation on 11/17/25 indicated that the resident’s daughter was informed via telephone about the NOMNC and the last covered day of 11/18/25. The CEO confirmed that the NOMNC should have been signed 48 hours before the end of skilled nursing coverage and acknowledged that this did not occur. Resident #81 had been admitted with multiple diagnoses, including post-surgical repair of a left femur fracture and muscle weakness, and was receiving skilled nursing facility services under Medicare Part A at the time the deficient notification occurred. The surveyors determined that this failure to provide timely NOMNC had the potential to cause financial harm or distress to residents by not informing them of their potential liability for payment when Medicare Part A benefits ended.
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