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PRINTED: 01/19/2023
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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Healthcare professionals such as doctors, nurses, pharmacists, and therapists who are required to hold a state license.
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What is state licensure survey and?
State licensure survey is a survey required by the state licensing board to gather information about licensed professionals.
Who is required to file state licensure survey and?
All licensed professionals are required to file state licensure survey.
How to fill out state licensure survey and?
State licensure survey can usually be filled out online through the state licensing board's website.
What is the purpose of state licensure survey and?
The purpose of state licensure survey is to ensure that licensed professionals are maintaining compliance with state regulations.
What information must be reported on state licensure survey and?
Information such as contact information, license number, continuing education hours, and any disciplinary actions must be reported on state licensure survey.
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