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This document outlines the findings from the Centers for Medicare & Medicaid Services survey at Alexandria Care Center, identifying deficiencies in care and the relevant plan of correction submitted by the provider. The document includes details on compliance with regulations regarding the care of residents with mental disorders, administration of medications, and the provision of necessary services.
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How to fill out cms-2567
How to fill out cms-2567
01
Gather necessary information about the facility being surveyed.
02
Review the survey findings and identify deficiencies.
03
Open the CMS-2567 form and fill in the facility's name, address, and CMS number at the top.
04
Document the citation dates and the survey type.
05
List all deficiencies in detail, including the regulatory citations and a description of the issue.
06
Provide the corrective actions taken or planned by the facility for each deficiency.
07
Sign and date the form after completing all entries.
Who needs cms-2567?
01
Healthcare facilities that undergo inspections and surveys by the Centers for Medicare & Medicaid Services (CMS) need CMS-2567.
02
Facilities that have been cited for non-compliance with health and safety regulations are also required to complete this form.
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What is cms-2567?
CMS-2567 is a form used by nursing homes and other long-term care facilities to report deficiencies in their practices, policies, or procedures as part of the inspection and survey process mandated by the Centers for Medicare & Medicaid Services (CMS).
Who is required to file cms-2567?
Nursing homes and other healthcare facilities that receive federal funding through Medicare and Medicaid are required to file CMS-2567 when deficiencies are identified during inspections or surveys.
How to fill out cms-2567?
CMS-2567 should be filled out by providing detailed information about each deficiency, including the scope and severity of the issue, the specific regulation violated, and a plan for correction. Facilities typically review survey results before completing the form.
What is the purpose of cms-2567?
The purpose of CMS-2567 is to document deficiencies found during surveys, providing a formal record that allows facilities to develop plans for correction and ensure compliance with federal standards.
What information must be reported on cms-2567?
The CMS-2567 must include information such as the name of the facility, the date of the survey, specific deficiencies observed, the regulation numbers involved, and the plan of correction to address each deficiency.
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