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QUESTION

Which of the following scenarios would be considered "proper notice" when issuing the NOMNC, CMS 10123? The resident is informed that Medicare services are ending today and facility staff can coordin

George Jackson is an 89-year-old resident being re-admitted from the hospital after a right leg, below the knee, amputation, due to diabetes mellitus. He has Medicare Part A benefit days available. He will not be ready for skilled rehabilitation for prosthesis training until the stump heals. In the meantime, Mr. Jackson’s nurse will be developing his care plan after assessing his care needs, which include skin care, oral medications, a diabetic diet, an exercise program to preserve muscle tone and body condition, and observation to detect signs of deterioration in his condition or complications resulting from his restricted, but increasing, mobility.

Which of the following statement is true?

He should be issued a denial letter on admission since he doesn’t require a skilled level of care.

Because of the complexities of his non-skilled services, he can be covered for daily development and management of the care plan until the care plan is essentially set.

He cannot be covered on Medicare Part A skilled services since he is not ready for skilled rehab at the time of discharge from acute care.

He does not meet skilled Medicare coverage criteria. The facility needs to issue a Notice of Medicare Non-Coverage beneficiary notice upon reentry back into the facility.

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