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PRINTED: 08/23/2016 FORM APPROVED Indiana State Department of Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER: FRANCISCAN ST ELIZABETH HEALTH
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2016 Indiana IAC Licensure X2 IN00203617 LSC X3 X5 QA X6 X1 40OX11 CLIA jlh X4 Substantiated REFERENCED DEFICIENCIES FRANCISCAN REGULATORY PREFIX continuation CORRECTIVE PRECEDED cited LAFAYETTE compliance DEFICIENCY CREASY PROVIDER SUMMARY

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