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This document outlines the results of a survey conducted at Golden Living Center-Fountainview, highlighting deficiencies related to resident care and infection control, as well as the facility\'s plan of correction in response to identified issues. It includes details on complaints, findings regarding compliance with federal and state regulations, and corrective actions taken by the facility.
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How to fill out cms-2567
How to fill out cms-2567
01
Obtain the CMS-2567 form from the official CMS website or your state agency.
02
Fill out the facility's identifying information such as name, address, and contact details.
03
Indicate the date of the survey and the date the report is being filled out.
04
Provide a summary of the survey findings and deficiencies observed.
05
Use appropriate codes and descriptions for each deficiency identified during the survey.
06
Detail any corrective actions that have been taken or are planned to address the deficiencies.
07
Include signature lines for both the surveyor and the facility representative.
08
Review the completed form for accuracy and completeness before submission.
Who needs cms-2567?
01
Healthcare facilities that are surveyed by CMS or state health agencies for compliance with federal health and safety standards.
02
Facilities seeking to document deficiencies and corrective actions for regulatory compliance.
03
Organizations needing to respond to findings of a survey or inspection.
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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 participate in Medicare and Medicaid programs are required to file CMS-2567 following a survey that identifies deficiencies.
How to fill out cms-2567?
To fill out CMS-2567, providers must accurately document the deficiencies identified during a survey, including a description of the deficiency, relevant regulations, and a plan for correction.
What is the purpose of cms-2567?
The purpose of CMS-2567 is to provide a systematic way to communicate deficiencies that need to be corrected in healthcare facilities to ensure compliance with federal requirements.
What information must be reported on cms-2567?
CMS-2567 must report information such as the facility's name and address, the date of the survey, the specific deficiencies identified, and the corrective actions planned.
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