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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES01/17/2012FORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES OMB NO. 09380391STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION
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01
Read the instructions provided by the ISDH healthcare facility thoroughly
02
Start by gathering all the necessary information and documentation required
03
Make sure to have a reliable internet connection and access to a computer or mobile device
04
Visit the official ISDH website and navigate to the healthcare facility section
05
Locate and click on the 'Fill Out' or 'Apply' button for the healthcare facility form
06
Fill out the form accurately and completely, providing all the requested details
07
Double-check the information entered for any errors or mistakes
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Submit the completed form electronically or follow the instructions provided for offline submission
09
Wait for a confirmation or acknowledgment from ISDH regarding the submission
10
Follow up, if necessary, to ensure the status of the healthcare facility application

Who needs isdh health care facility?

01
Healthcare facilities such as hospitals, clinics, nursing homes, and long-term care facilities need ISDH healthcare facility forms
02
Healthcare professionals and administrators responsible for managing and operating healthcare facilities require ISDH healthcare facility forms
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Individuals or organizations seeking licenses or permits related to healthcare facilities may need to fill out ISDH healthcare facility forms
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Government agencies or regulatory bodies involved in monitoring and overseeing healthcare facilities may need access to ISDH healthcare facility forms
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ISDH health care facility refers to a facility that provides medical services such as hospitals, nursing homes, outpatient centers, etc.
Any health care facility operating in Indiana is required to file ISDH health care facility report.
ISDH health care facility report can be filled out online on the ISDH website or by submitting a physical form.
The purpose of ISDH health care facility report is to ensure that health care facilities are operating in compliance with state regulations and are providing quality care to patients.
Information such as number of patients treated, types of services offered, staffing levels, infection control measures, etc. must be reported on ISDH health care facility report.
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