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This document outlines the deficiencies observed during a health and safety survey conducted by the Centers for Medicare & Medicaid Services (CMS) at Bladen East Health and Rehab, LLC. It includes the provider\'s plan for correcting identified deficiencies and confirms that the facility achieved substantial compliance as of 10/08/2024.
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How to fill out cms-2567
How to fill out cms-2567
01
Obtain the CMS-2567 form from the CMS website or your state survey agency.
02
Fill in the provider's name, address, and other identifying information at the top of the form.
03
Include the date of the survey and the agency's unique identification number.
04
List all deficiencies found during the survey, including the specific regulation violated.
05
Provide a narrative description of each deficiency, including the evidence and findings.
06
Assign a tag number to each deficiency for easy reference.
07
Include the scope and severity rating for each deficiency identified.
08
Enter any comments or additional information that may be relevant.
09
Review the completed form for accuracy and completeness.
10
Submit the CMS-2567 form to the appropriate CMS regional office.
Who needs cms-2567?
01
The CMS-2567 form is required by healthcare providers and facilities that are subject to Medicare and Medicaid regulations.
02
It is needed by state agencies conducting surveys to assess compliance with federal regulations.
03
Healthcare organizations that need to document deficiencies found during surveys will also use this form.
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What is cms-2567?
CMS-2567 is a form used by healthcare facilities to report their compliance with certain health and safety standards set by the Centers for Medicare & Medicaid Services (CMS).
Who is required to file cms-2567?
Healthcare facilities participating in Medicare and Medicaid programs are required to file CMS-2567 to report their compliance status.
How to fill out cms-2567?
To fill out CMS-2567, facilities must provide information regarding their compliance with federal regulations, including specific citations of deficiencies and corrective actions taken.
What is the purpose of cms-2567?
The purpose of CMS-2567 is to document and communicate the findings of health and safety compliance inspections, helping to ensure that healthcare facilities maintain the required standards.
What information must be reported on cms-2567?
CMS-2567 must report the facility's name, address, survey date, specific deficiencies cited, and plans for correction.
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