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Get the free www.in.gov health reportsFORM CMS-2567 (02/99) Previous Versions Obsolete Event ID ...

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03/04/2019PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION
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The CMS-2567 form is also known as the Health Facility Survey Report and is used by healthcare providers to report compliance with federal regulations.
Healthcare facilities that participate in Medicare and Medicaid programs are required to file the CMS-2567 form.
To fill out the CMS-2567 form, facilities must provide detailed information about their compliance with regulations, including areas of deficiency and plans for correction.
The purpose of the CMS-2567 form is to document compliance with health and safety standards in healthcare facilities and to outline any deficiencies.
The form requires information regarding the survey findings, areas of non-compliance, and a timeline for corrective actions taken by the facility.
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