Form preview

Get the free This visit resulted in an Extended Survey Substandard Quality of Care

Get Form
08/15/2018PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign this visit resulted in

Edit
Edit your this visit resulted in form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your this visit resulted in form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit this visit resulted in online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Use the instructions below to start using our professional PDF editor:
1
Create an account. Begin by choosing Start Free Trial and, if you are a new user, establish a profile.
2
Upload a file. Select Add New on your Dashboard and upload a file from your device or import it from the cloud, online, or internal mail. Then click Edit.
3
Edit this visit resulted in. Rearrange and rotate pages, add new and changed texts, add new objects, and use other useful tools. When you're done, click Done. You can use the Documents tab to merge, split, lock, or unlock your files.
4
Save your file. Select it in the list of your records. Then, move the cursor to the right toolbar and choose one of the available exporting methods: save it in multiple formats, download it as a PDF, send it by email, or store it in the cloud.
It's easier to work with documents with pdfFiller than you can have ever thought. You can sign up for an account to see for yourself.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out this visit resulted in

Illustration

How to fill out this visit resulted in

01
Start by gathering all the necessary information and documents required for the visit.
02
Make sure you have a clear understanding of the purpose and objectives of the visit.
03
Plan the visit schedule and make any necessary arrangements such as transportation and accommodation.
04
On the day of the visit, arrive at the designated location or venue on time.
05
Follow any instructions or guidelines provided by the host or organizer of the visit.
06
Engage in meaningful interactions and discussions during the visit to gather information or achieve the desired outcomes.
07
Take notes or record important observations or findings during the visit.
08
Ask any relevant questions or seek clarification whenever necessary.
09
Follow up after the visit with any required reports or follow-up actions as discussed or agreed upon during the visit.
10
Evaluate the visit and reflect on its effectiveness or impact, identifying any areas for improvement for future visits.

Who needs this visit resulted in?

01
Anyone who requires or desires to gather firsthand information or experience related to a specific subject, event, or location.
02
Researchers, students, journalists, business professionals, or government officials may need this visit to gather data, conduct interviews, or assess a situation.
03
Individuals or organizations involved in planning, decision-making, or evaluation processes may also need this visit to inform their actions or strategies.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.7
Satisfied
54 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

this visit resulted in is ready when you're ready to send it out. With pdfFiller, you can send it out securely and get signatures in just a few clicks. PDFs can be sent to you by email, text message, fax, USPS mail, or notarized on your account. You can do this right from your account. Become a member right now and try it out for yourself!
The editing procedure is simple with pdfFiller. Open your this visit resulted in in the editor, which is quite user-friendly. You may use it to blackout, redact, write, and erase text, add photos, draw arrows and lines, set sticky notes and text boxes, and much more.
Download and install the pdfFiller iOS app. Then, launch the app and log in or create an account to have access to all of the editing tools of the solution. Upload your this visit resulted in from your device or cloud storage to open it, or input the document URL. After filling out all of the essential areas in the document and eSigning it (if necessary), you may save it or share it with others.
This visit resulted in an inspection report.
The inspector who conducted the visit is required to file the report.
The visit report should be filled out with detailed information about the inspection findings.
The purpose of this visit resulted in is to document the findings of the inspection.
The report must include details of the inspection, any violations found, and recommendations for corrective actions.
Fill out your this visit resulted in online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.