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PRINTED: 06/29/2017 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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How to fill out nc dhsr licensed facilitiesdivision

01

Obtain the necessary forms and applications from the North Carolina Division of Health Service Regulation (DHSR) website or office.

02

Fill out the forms completely and accurately, providing all required information such as facility name, address, contact information, and type of facility.

03

Include any supporting documentation or additional materials as specified in the application instructions.

04

Submit the completed application and any fees required to the DHSR for review and processing.

05

Provide any additional information or follow-up documentation as requested by the DHSR during the licensing process.

06

Await approval and issuance of the license from the DHSR before operating the facility.

Who needs nc dhsr licensed facilitiesdivision?

01

Any individual or organization wishing to operate a licensed facility in North Carolina, such as nursing homes, adult care homes, hospitals, ambulatory surgical facilities, and mental health facilities, needs to apply for and obtain a DHSR licensed facilitiesdivision.

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What is nc dhsr licensed facilitiesdivision?

The NC DHSR Licensed Facilities Division is responsible for overseeing and regulating licensed facilities in North Carolina.

Who is required to file nc dhsr licensed facilitiesdivision?

Any facility that is licensed by the NC DHSR is required to file the licensed facilities division.

How to fill out nc dhsr licensed facilitiesdivision?

The NC DHSR Licensed Facilities Division form can be filled out online through the NC DHSR website or submitted by mail.

What is the purpose of nc dhsr licensed facilitiesdivision?

The purpose of the NC DHSR Licensed Facilities Division is to ensure compliance with state regulations and standards for licensed facilities in North Carolina.

What information must be reported on nc dhsr licensed facilitiesdivision?

The NC DHSR Licensed Facilities Division form requires information about the facility’s operations, staff, services provided, and compliance with regulations.

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