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PRINTED: 01/09/2024 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION
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Obtain the regency health and rehabilitation form from the facility or online.
02
Fill in personal information such as name, address, date of birth, and contact information.
03
Provide details about your medical history, including any previous injuries or illnesses.
04
List any current medications you are taking, including dosage and frequency.
05
Include information about your insurance coverage, if applicable.
06
Sign and date the form to certify that all information provided is accurate.
07
Submit the completed form to the appropriate department at the facility.

Who needs regency health and rehabilitation?

01
Patients recovering from surgery or a serious illness.
02
Individuals needing assistance with activities of daily living such as bathing, dressing, and eating.
03
Elderly individuals requiring skilled nursing care and rehabilitation services.
04
People with chronic medical conditions that require ongoing treatment and monitoring.
05
Those in need of specialized therapy services such as physical, occupational, or speech therapy.
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Regency health and rehabilitation refers to a specific type of health care program or services focused on recovery and rehabilitation for individuals with health issues, disabilities, or those needing post-operative care. It typically encompasses various therapies, health assessments, and support services aimed at helping patients regain independence.
Individuals who are participants in or beneficiaries of the regency health and rehabilitation program, as well as health care providers and facilities involved in delivering services under the program, are required to file relevant documentation.
To fill out the regency health and rehabilitation forms, you should gather all required personal and medical information, accurately complete each section of the form, include necessary documentation, and ensure signatures are obtained where required before submitting the application.
The purpose of regency health and rehabilitation is to provide comprehensive care and support to individuals recovering from injuries or illnesses, promote physical and mental well-being, and assist patients in achieving optimal functioning and quality of life.
Necessary information to report typically includes patient identification details, medical history, current health conditions, types of rehabilitation services received, and outcomes of the treatment process.
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