Based on interviews and record review, the facility failed to provide the correct Center for Medicare and Medicaid (CMS) Form 10055, Advanced Beneficiary Notice (ABN), for Resident (R)33 and R96. Findings included:- The Medicare ABN form informed the beneficiaries Medicare may not pay for future skilled therapy and did not provide an estimated cost to continue their services. The form included options for the beneficiary to receive specified services listed and bill Medicare for an official decision on payment. I understand if Medicare does not pay, I will be responsible for payment, but I can appeal to Medicare. (2) receive therapy listed, but do not bill Medicare, I am responsible for payment of services. (3) I do not want the listed services. …
F582 citations in Kansas
Medicare and Medicaid notices · Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Kansas cites F582 more often than its own record predicts
2.81 times the share F582 takes of citations nationally.
Of every deficiency written in Kansas in 2025, this is the portion that was F582.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Kansas surveyors wrote
F582 findings written in Kansas, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
The facility identified a census of 54. The sample included 14 residents with four residents reviewed for beneficiary notification. Based on record review and interviews, the facility failed to provide the correct Form CMS 10055- Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN) to Resident (R) 56 and R57 and/or their representative.Findings included:- Upon request of the Medicare Liability Notice, CMS 101123- Notice of Medicare Non-Coverage (NOMNC) and SNF ABN for R56, the facility provided a NOMNC and an ABN for R56. The NOMNC documented R56's covered services ended on 11/19/25 and R56 and/or his representative received the NOMNC and ABN on 11/17/25. …
The short window
Recent years
| Year | Share of Kansas citations | vs expected |
|---|---|---|
| 2023 | 1.43% | 2.63× |
| 2024 | 1.39% | 2.64× |
| 2025 | 1.14% | 2.81× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Kansas surveyors cite →
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