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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTIONPRINTED:05/16/2020 FORM APPROVED OMB NO. 09380391 (X3) DATE SURVEY

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Start by carefully reading the instructions provided for the nursing home survey report.

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Gather all necessary information such as patient demographics, medical history, and current conditions.

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Use the appropriate coding and documentation guidelines when filling out each section of the report.

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Double check all information entered for accuracy and completeness before submitting the report.

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Who needs nursing home survey report?

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Healthcare providers

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Regulatory agencies

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Insurance companies

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Government agencies

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Nursing home administrators

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What is nursing home survey report?

Nursing home survey report is a document that provides information on the quality of care and services provided by a nursing home.

Who is required to file nursing home survey report?

Nursing homes are required to file nursing home survey reports.

How to fill out nursing home survey report?

Nursing home survey reports are filled out by gathering data on various aspects of care and services provided by the nursing home.

What is the purpose of nursing home survey report?

The purpose of nursing home survey report is to assess the quality of care provided by nursing homes and ensure compliance with regulations.

What information must be reported on nursing home survey report?

Information such as staffing levels, resident care plans, medication administration, and health and safety measures must be reported on nursing home survey report.

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