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Printed: 06/30/2024 Form Approved OMB No. 09380391Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA
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Start by gathering all necessary information such as personal details, insurance information, and medical history.
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Fill out the patient's demographics including name, address, phone number, and date of birth.
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Provide the healthcare provider's information including name, address, and contact details.
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Detail the reason for seeking rehabilitation and care at Lakeside Rehabilitation and Care facility.
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Answer all questions honestly and thoroughly to provide the most accurate information for the healthcare team.

Who needs lakeside rehabilitation and care?

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Individuals who require specialized rehabilitation and care services following an injury or surgery.
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Patients who need assistance with activities of daily living due to a chronic illness or disability.
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Elderly individuals who need supervised care and therapy to improve their quality of life.
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People recovering from a stroke, heart attack, or other medical conditions that require intensive rehabilitation.
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Lakeside rehabilitation and care is a facility that provides medical and therapeutic services to individuals who require rehabilitation or long-term care.
Lakeside rehabilitation and care facilities are required to file reports with the appropriate regulatory agencies and insurance companies.
The report for lakeside rehabilitation and care should be filled out accurately and completely, including information about patient care, staffing, and facility operations.
The purpose of lakeside rehabilitation and care is to provide high-quality care and therapy to individuals who need assistance with recovery or long-term care.
Information that must be reported on lakeside rehabilitation and care includes patient demographics, medical history, treatment plans, staff credentials, and facility compliance.
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