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PRINTED: 05/24/2021 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 plan of correction

01
Identify the deficiencies or violations that need to be corrected
02
Develop a detailed plan outlining the steps to correct each deficiency
03
Assign responsibilities to individuals or departments for each corrective action
04
Set deadlines for completing each corrective action
05
Submit the plan of correction to the appropriate regulatory agency for approval

Who needs plan of correction?

01
Healthcare facilities
02
Long-term care facilities
03
Home health agencies
04
Hospices
05
Other healthcare organizations regulated by government agencies
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A plan of correction is a formal document that outlines how an organization intends to address deficiencies found in an evaluation or inspection, ensuring compliance with applicable regulations.
Typically, facilities or organizations that have been cited for violations or deficiencies during inspections are required to file a plan of correction.
To fill out a plan of correction, identify the issues cited, outline specific steps to correct them, assign responsibilities, set timelines for completion, and provide evidence of changes made.
The purpose of a plan of correction is to ensure that identified deficiencies are addressed promptly and adequately, thereby improving compliance and quality of care or services provided.
A plan of correction must report the specific deficiencies, corrective actions planned, responsible parties, completion dates, and any measures taken to prevent future occurrences.
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