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This document outlines the findings of a survey conducted by the Centers for Medicare & Medicaid Services regarding the compliance of Owen Valley Rehabilitation and Healthcare Center with health regulations. It includes details of a complaint investigation, deficiencies found, and the provider\'s plan for correction.
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How to fill out cms-2567
How to fill out cms-2567
01
Obtain the CMS-2567 form from the relevant website or office.
02
Begin with the provider's information, including name, address, and facility type.
03
Enter the date of the survey or investigation.
04
List the deficiencies identified during the survey, providing specific details for each.
05
Include the regulatory citations for each deficiency found.
06
Describe the harm or potential harm caused by the deficiencies.
07
Indicate the plan of correction for each deficiency.
08
Review the completed form for accuracy and completeness.
09
Submit the form to the appropriate CMS regional office.
Who needs cms-2567?
01
Healthcare facilities that are surveyed by CMS, including hospitals, nursing homes, and home health agencies.
02
Providers involved in the Medicare and Medicaid programs.
03
Facilities that receive findings from a CMS inspection or investigation.
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What is cms-2567?
CMS-2567 is a form used by healthcare providers to report deficiencies found during surveys conducted by the Centers for Medicare & Medicaid Services (CMS).
Who is required to file cms-2567?
Healthcare facilities that receive Medicare and Medicaid funding and are subject to regulatory surveys are required to file CMS-2567.
How to fill out cms-2567?
To fill out CMS-2567, facilities must provide detailed information about deficiencies, corrective actions taken, and relevant timelines.
What is the purpose of cms-2567?
The purpose of CMS-2567 is to document the results of surveys, ensuring that healthcare facilities comply with federal standards and regulations.
What information must be reported on cms-2567?
CMS-2567 must report specifics of the deficiencies, including the regulation violated, the nature of the deficiency, and actions for corrective measures.
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