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This document contains a detailed report of deficiencies observed during a survey of the Community Nursing and Rehabilitation Center, located at 5600 E 16th St, Indianapolis, IN. It outlines the regulatory infractions found, corrective actions proposed by the facility, and plans for ensuring compliance. It emphasizes the importance of resident rights, quality of care, sanitation, and proper medical record management, as well as the failure to maintain certain standards in ADLs and the call...
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How to fill out cms-2567
How to fill out cms-2567
01
Obtain a copy of the CMS-2567 form from the official website or your local CMS office.
02
Fill out the facility identification section with the name, address, and type of facility.
03
Enter the date of the survey or inspection in the designated field.
04
Review the deficiencies and violations observed during the survey and document them accurately.
05
Provide detailed explanations for each deficiency, including the relevant regulation or standard.
06
Include any corrective actions taken or planned to address the deficiencies.
07
Ensure that the form is signed and dated by the appropriate authority before submission.
08
Submit the completed form to the appropriate CMS regional office.
Who needs cms-2567?
01
Long-term care facilities receiving Medicare or Medicaid funding
02
Healthcare providers undergoing Medicare or Medicaid certification surveys
03
Facilities seeking to address deficiencies identified during inspections
04
State and federal surveyors responsible for evaluating facility compliance
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What is cms-2567?
CMS-2567 is a form used by healthcare facilities to report deficiencies identified during inspections and surveys.
Who is required to file cms-2567?
Healthcare facilities that receive Medicare or Medicaid funding are required to file CMS-2567 when deficiencies are identified.
How to fill out cms-2567?
To fill out CMS-2567, facilities must document specific deficiencies, corrective actions taken, and relevant information as required by the form's guidelines.
What is the purpose of cms-2567?
The purpose of CMS-2567 is to ensure that healthcare facilities address identified deficiencies and comply with health and safety standards.
What information must be reported on cms-2567?
Information that must be reported includes the nature of the deficiency, the date it was identified, and the corrective actions taken by the facility.
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