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PRINTED: 04/05/2024 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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A licensure survey is completed on the compliance of an organization or facility with specific regulatory standards required for licensing.
Organizations and facilities that are seeking or renewing a license in accordance with state or federal regulations are required to file a licensure survey.
To fill out a licensure survey, follow the provided guidelines, answer all questions accurately, gather necessary documentation, and submit the survey to the appropriate regulatory body.
The purpose of a licensure survey is to assess compliance with regulatory standards and ensure that the organization or facility meets the necessary requirements for operation.
Information such as facility details, ownership, staffing, policies and procedures, and compliance with health and safety standards must be reported on the licensure survey.
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