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PRINTED: 01/29/2015 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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To fill out the NC DHSR Const Statement, follow these steps:
02
Begin by providing the project name, project address, and the name of the facility or organization.
03
Fill in the contact information, including the name, phone number, and email address of the person responsible for the construction project.
04
Specify the type of construction being undertaken, whether it is new construction, renovation, or alteration.
05
Indicate the occupancy classification for the project, such as healthcare, residential, institutional, or commercial.
06
Provide a brief description of the scope of work, including any major components or systems being added or modified.
07
Attach any supporting documents or plans that are required to be submitted along with the const statement.
08
Sign and date the const statement to certify the accuracy of the information provided.
09
Submit the completed const statement to the appropriate authority or agency as per their instructions.

Who needs nc dhsr const statement?

01
The NC DHSR Const Statement is required by individuals or organizations involved in construction projects in North Carolina.
02
This statement is typically needed for projects in the healthcare, residential, institutional, or commercial sectors.
03
Builders, contractors, architects, engineers, and property owners may need to fill out the NC DHSR Const Statement.
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The NC DHSR Const Statement refers to the North Carolina Division of Health Service Regulation Construction Statement.
Individuals or businesses involved in construction projects that fall under the jurisdiction of the North Carolina Division of Health Service Regulation are required to file the NC DHSR Const Statement.
The NC DHSR Const Statement can be filled out online through the Division's official website by providing the necessary project details and information.
The purpose of the NC DHSR Const Statement is to ensure that construction projects comply with health service regulations and to track construction activities in the state of North Carolina.
The NC DHSR Const Statement typically requires information such as project details, contractor information, construction timeline, and compliance with health service regulations.
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