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Printed: 09/01/2024 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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Obtain a copy of the admission form from Edgewood Manor Rehabilitation Healthcare.
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Fill out all required personal information accurately, including name, address, date of birth, and contact information.
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Provide details about medical history, current medications, and any allergies you may have.
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Indicate any specific care needs or preferences you have that should be taken into consideration during your stay.
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Sign and date the form once you have completed all sections.
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Submit the completed form to the staff at Edgewood Manor Rehabilitation Healthcare for processing.

Who needs edgewood manor rehabilitation healthcare?

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Individuals who require specialized rehabilitation services following surgery or a medical procedure.
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Elderly individuals who need assistance with daily activities and medical care.
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Patients recovering from a stroke, injury, or other medical condition that requires intensive therapy and support.
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Those in need of long-term care and support due to chronic illness or disability.
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Edgewood Manor Rehabilitation Healthcare is a healthcare facility that provides various rehabilitation services, including physical, occupational, and speech therapy, to individuals recovering from illness, injury, or surgery.
Individuals or healthcare professionals referring patients to Edgewood Manor Rehabilitation Healthcare, as well as the facility itself for regulatory compliance, may be required to submit documentation.
To fill out Edgewood Manor Rehabilitation Healthcare forms, you will need to gather patient information, including medical history, therapy needs, and any other relevant documentation, and complete the forms accurately according to the facility's guidelines.
The purpose of Edgewood Manor Rehabilitation Healthcare is to assist patients in regaining functionality, improving their quality of life, and facilitating their recovery through specialized rehabilitation services.
Required information typically includes patient identification, medical history, details of rehabilitation services needed, insurance information, and consent forms.
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