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PRINTED: 08/14/2019 FORM APPROVED Indiana State Department of Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:LUTHERAN HOSPITAL OF INDIANA (X4)

How to fill out this plan of correction

How to fill out this plan of correction

1. Begin by reviewing the specific requirements outlined in the plan of correction.
2. Collect all necessary information and supporting documentation to address each requirement.
3. Divide the plan of correction into sections or categories, corresponding to each requirement.
4. Start with the first section and provide a detailed description of the actions or steps that will be taken to address the requirement.
5. Clearly state any additional resources or personnel that will be involved in implementing the plan of correction.
6. Include a timeline or schedule for completing each action or step.
7. Provide any necessary details or specifications for the actions to be taken.
8. Move on to the next section and repeat the process until all requirements are addressed.
9. Double-check the plan of correction for clarity, completeness, and accuracy.
10. Submit the plan of correction to the relevant authority or organization as required.

Who needs this plan of correction?

1. This plan of correction is typically needed by organizations or entities that have been found to be non-compliant with certain regulations or standards.
2. These can include healthcare facilities, educational institutions, government agencies, and other entities that require a plan to rectify any identified deficiencies.
3. It is also needed by individuals or teams responsible for overseeing compliance and quality assurance within an organization.

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What is this plan of correction?

A plan of correction is a formal document submitted by an organization to address and rectify deficiencies identified by regulatory authorities or during audits.

Who is required to file this plan of correction?

Typically, licensed facilities, healthcare providers, or other entities subject to regulatory oversight who have been found non-compliant with applicable regulations are required to file a plan of correction.

How to fill out this plan of correction?

To fill out the plan of correction, follow the guidelines provided by the regulatory body, addressing each deficiency identified, outlining corrective actions, assigning responsibilities, and establishing timelines for implementation.

What is the purpose of this plan of correction?

The purpose of the plan of correction is to demonstrate the organization's commitment to resolving identified issues, maintaining compliance, and improving overall operational quality.

What information must be reported on this plan of correction?

The plan must include details on the specific deficiencies, corrective actions taken or planned, responsible parties, timelines for completion, and follow-up monitoring methods.