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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:15529801/13/2014FORM
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How to fill out in00140013 substantiated federalstate deficiencies

01
Review the list of substantiated federal/state deficiencies provided by the regulatory agency.
02
Document all the information related to each deficiency, including the date of occurrence, specific regulation violated, and corrective action taken.
03
Develop a plan of correction for each deficiency, addressing the root cause and outlining steps to prevent recurrence.
04
Submit the completed in00140013 form with all supporting documentation to the regulatory agency within the specified timeframe.
05
Follow up with the regulatory agency to ensure that all deficiencies have been addressed and accepted.

Who needs in00140013 substantiated federalstate deficiencies?

01
Healthcare facilities and providers who have been found to be in violation of federal or state regulations and have been issued substantiated deficiencies by the regulatory agency.
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In00140013 substantiated federalstate deficiencies refer to documented findings of violations or non-compliance with federal and state regulations.
Healthcare facilities and providers are required to file in00140013 substantiated federalstate deficiencies.
To fill out in00140013 substantiated federalstate deficiencies, complete the required sections with detailed information about the violations or non-compliance.
The purpose of in00140013 substantiated federalstate deficiencies is to report and address any violations of federal and state regulations in healthcare settings.
Information such as the nature of the violation, date of occurrence, corrective actions taken, and any supporting documentation must be reported on in00140013 substantiated federalstate deficiencies.
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