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PRINTED: 06/28/2018 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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01
To fill out the NC DHSR Licensed Facilities Division application, follow these steps:
02
Gather all necessary documents and information, such as your facility's name, address, and license number.
03
Visit the NC DHSR Licensed Facilities Division website.
04
Locate the application form for the specific type of license you need.
05
Download or print the application form.
06
Fill out the application form accurately and completely, answering all required questions.
07
Attach any supporting documents as specified in the application form instructions.
08
Review the completed application form to ensure it is error-free and all necessary information is included.
09
Submit the application form and supporting documents to the NC DHSR Licensed Facilities Division either by mail or online, following the provided instructions.
10
Pay any required fees associated with the application.
11
Wait for the review and processing of your application by the NC DHSR Licensed Facilities Division.
12
Once approved, you will receive your license or further instructions from the division.

Who needs nc dhsr licensed facilitiesdivision?

01
Any facility in North Carolina that provides health services, such as hospitals, nursing homes, adult care homes, mental health facilities, and other healthcare organizations, needs to obtain an NC DHSR Licensed Facilities Division license.
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NC DHSR Licensed Facilities Division refers to the division within the North Carolina Department of Health and Human Services that oversees licensing for various healthcare facilities.
Healthcare facilities and providers in North Carolina are required to file with the NC DHSR Licensed Facilities Division in order to obtain and maintain licensure.
To fill out the NC DHSR Licensed Facilities Division paperwork, you must provide detailed information about your healthcare facility or practice, including staff credentials, services offered, and compliance with regulations.
The purpose of NC DHSR Licensed Facilities Division is to ensure that healthcare facilities in North Carolina meet state regulations and standards for quality of care and patient safety.
Information that must be reported on the NC DHSR Licensed Facilities Division forms includes facility name, location, services provided, staff credentials, and compliance with state regulations.
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