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This document outlines the findings of deficiencies in care and services at REM-Indiana Inc located in Merrillville, IN, based on surveys conducted from January 24 to February 1, 2023. It includes a summary of deficiencies related to governing body management, health care services, nursing services, and drug administration, along with corrective action plans implemented 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 CMS website or your local CMS office.
02
Read the instructions carefully to ensure understanding of the requirements.
03
Fill in the facility's name, address, and other identifying information at the top of the form.
04
Provide a summary of the findings in the 'Summary Statement' section.
05
Detail the specific deficiencies in the 'Deficiencies' section, including references to regulatory standards.
06
Indicate the severity and scope of each deficiency.
07
Include any corrective actions that have been taken or are planned.
08
Review the completed form for accuracy.
09
Submit the CMS-2567 form to the appropriate CMS regional office.
Who needs cms-2567?
01
Healthcare facilities that have undergone inspections by the Centers for Medicare & Medicaid Services (CMS).
02
Facilities that need to report deficiencies identified during surveys.
03
Organizations applying for Medicare certification or re-certification.
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What is cms-2567?
CMS-2567 is a form used by healthcare providers to report deficiencies found during a survey or inspection, specifically related to compliance with Medicare and Medicaid requirements.
Who is required to file cms-2567?
Healthcare facilities that participate in Medicare and Medicaid programs are required to file CMS-2567 when deficiencies are identified during a survey.
How to fill out cms-2567?
To fill out CMS-2567, providers must provide details of the deficiencies identified, including the specific regulation violated, a description of the deficiency, and the date of the survey.
What is the purpose of cms-2567?
The purpose of CMS-2567 is to formally document deficiencies found during surveys, enabling facilities to address and correct issues to maintain compliance with federal standards.
What information must be reported on cms-2567?
Information required includes facility name and address, survey dates, details of each deficiency, regulation citations, and plans for correction.
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