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This document outlines the deficiencies found during the survey of Life Care Center of Rochester, as well as the provider\'s plan of correction to address these deficiencies. The survey was completed on February 18, 2020, and the facility was found to be in compliance with relevant regulations.
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How to fill out cms-2567

01
Obtain a copy of the CMS-2567 form, which can be downloaded from the official CMS website.
02
Provide the facility name, address, and the specific date of the survey or the incident being reported.
03
Fill in the appropriate section detailing the findings from the survey, including the regulatory citations and the date of each deficiency.
04
Include a summary of the corrective actions taken by the facility in response to the deficiencies noted.
05
Ensure that all information is accurate and complete before submission.
06
Sign and date the form where indicated to validate the information provided.

Who needs cms-2567?

01
Healthcare facilities that participate in Medicare and Medicaid programs.
02
Providers and suppliers that are subject to surveys and inspections by regulatory bodies.
03
Administrators responsible for maintaining compliance with health and safety regulations.
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CMS-2567 is a form used by healthcare providers to report deficiencies identified during inspections or surveys to the Centers for Medicare & Medicaid Services.
Healthcare facilities that receive funding from Medicare or Medicaid programs and are subject to inspections must file CMS-2567.
To fill out CMS-2567, facilities should accurately describe each deficiency noted during a survey, along with any corrective actions taken or planned.
The purpose of CMS-2567 is to ensure that healthcare facilities comply with federal health and safety standards and to facilitate accountability in healthcare services.
CMS-2567 requires reporting of the specific deficiencies, their severity, the date of the survey, and any actions taken by the facility to address them.
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