Get the free NC DHSR ACLS: Statement of Deficiency - NCDHHS

PRINTED: 04/21/2020 FORM APPROVEDDivision of Health Service Regulation STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:(X3) DATE SURVEY COMPLETED 04/16/2020STREET

How to fill out nc dhsr acls statement

How to fill out nc dhsr acls statement

1. To fill out the NC DHHS ACLS statement, you need to follow these steps:
2. Start by providing your personal information, including your name, address, and contact details.
3. Specify the facility or organization you are affiliated with and provide their contact information.
4. Indicate the type of the statement you are making and mention the specific program or service area.
5. Clearly state the purpose of the statement and provide any necessary details or explanations.
6. Provide any supporting documentation or evidence, if required.
7. Sign and date the statement to verify its authenticity and accuracy.
8. Make copies of the completed statement for your records.
9. Submit the filled-out statement to the appropriate DHHS office or department as instructed.
10. Follow up to ensure that your statement has been received and processed.
11. Remember to review the instructions and guidelines provided by NC DHHS for any additional requirements specific to your situation.

Who needs nc dhsr acls statement?

1. Various individuals and organizations may need to fill out the NC DHHS ACLS statement. These include:
2. - Healthcare professionals
3. - Residential care facilities
4. - Home care agencies
5. - Hospitals and clinics
6. - Rehabilitation centers
7. - Mental health facilities
8. - Long-term care facilities
9. - Assisted living communities
10. - Hospices
11. Anyone who needs to make a statement regarding their compliance with the rules, regulations, or standards set by the North Carolina Department of Health and Human Services (DHHS) may require the NC DHHS ACLS statement.

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What is nc dhsr acls statement?

The NC DHHS ACLS statement is a report required by the North Carolina Division of Health Service Regulation to ensure compliance with Advanced Cardiac Life Support certification standards.

Who is required to file nc dhsr acls statement?

Healthcare providers, facilities, and organizations engaged in emergency medical services or delivering cardiopulmonary resuscitation training in North Carolina are required to file the NC DHHS ACLS statement.

How to fill out nc dhsr acls statement?

To fill out the NC DHHS ACLS statement, you must provide details such as the organization's information, the number of trained personnel, certification expirations, and any other pertinent data as specified in the provided form.

What is the purpose of nc dhsr acls statement?

The purpose of the NC DHHS ACLS statement is to monitor and maintain high standards of Advanced Cardiac Life Support training and certification among healthcare providers in North Carolina.

What information must be reported on nc dhsr acls statement?

Information that must be reported includes the organization's name, address, contact details, number of personnel certified, renewal dates of certifications, and compliance with ACLS training requirements.