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PRINTED: 06/13/2022
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 an onsite revisit was

How to fill out an onsite revisit was
01
Gather all relevant information about the site visit such as previous findings, issues identified, and actions taken.
02
Schedule a date and time for the onsite revisit with the necessary parties involved.
03
Conduct a thorough walkthrough of the site to check if previous issues have been resolved and if any new issues have arisen.
04
Document any findings during the revisit and take note of any corrective actions that need to be taken.
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Who needs an onsite revisit was?
01
Anyone who has conducted a site visit and identified issues that require follow-up or verification.
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What is an onsite revisit was?
An onsite revisit was is a mandatory visit to a location or site to verify compliance with regulations.
Who is required to file an onsite revisit was?
Any individual or organization that is subject to regulations requiring onsite revisits.
How to fill out an onsite revisit was?
To fill out an onsite revisit was, one must visit the location, gather information, and report any findings.
What is the purpose of an onsite revisit was?
The purpose of an onsite revisit was is to ensure compliance with regulations and address any issues found.
What information must be reported on an onsite revisit was?
Information such as observations, findings, actions taken, and recommendations must be reported on an onsite revisit was.
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