Failure to Provide Required SNF-ABN Notice for Ending Medicare Part A Coverage
Penalty
Summary
The facility failed to provide the required CMS Skilled Nursing Facility Advanced Beneficiary Notice (SNF-ABN) form 10555 to residents whose Medicare Part A skilled services were ending while they remained in the facility. For one resident admitted to Medicare Part A skilled services on 11/6/25, Part A coverage ended on 11/28/25, but record review showed no documentation that the resident or responsible party received the SNF-ABN prior to discharge from Part A services. Instead, the Social Worker reported that on 11/26/25 she issued an Advance Beneficiary Notice of Non-Coverage form intended for Medicare Part B items and services, meaning the resident did not receive the correct Part A liability notice required by CMS. A second resident was admitted to Medicare Part A skilled services on 11/28/25, with Part A coverage ending on 12/17/25, and this resident also remained in the facility after skilled services ended. Record review again showed no documentation that the resident or responsible party received the SNF-ABN form 10555 prior to discharge from Part A services. The Social Worker stated it was her responsibility to issue the SNF-ABN and acknowledged that on 12/15/25 she provided the same incorrect Advance Beneficiary Notice of Non-Coverage form used for Medicare Part B instead of the required SNF-ABN. In an interview, the Administrator stated she was not aware that the Social Worker had been using the wrong form and confirmed that both residents should have received the CMS SNF-ABN form 10555 as required by federal guidelines.
We Help Long-Term Care Teams Stay Survey-Ready
We process and analyze inspection reports and plan of correction using AI to extract insights and trends so providers can improve care quality and stay ahead of compliance risks.