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This document outlines the findings and deficiencies identified during the survey of Hampton Oaks Health Campus, including the investigation details for Complaint IN00401855. It confirms compliance with applicable regulations and details the provider\'s plan of correction for any noted deficiencies.
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How to fill out cms-2567
How to fill out cms-2567
01
Begin by entering the identifying information of the facility at the top of the form.
02
Include the date of the survey and the surveyor's name.
03
List the type of services provided by the facility.
04
Provide information about the ownership and management of the facility.
05
Document each deficiency observed during the survey in detail.
06
Use clear language and specific examples for each deficiency.
07
Reference the applicable regulations for each cited deficiency.
08
Include corrective actions required by the facility for each deficiency.
09
Ensure to sign and date the form at the bottom.
Who needs cms-2567?
01
CMS-2567 is needed by healthcare facilities for documenting deficiencies found during inspections.
02
It is used by surveyors and inspectors to report compliance and regulatory issues.
03
Facilities undergoing CMS certification or recertification need this form.
04
State agencies may also require this form to ensure compliance with federal regulations.
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What is cms-2567?
CMS-2567 is a form used by healthcare facilities to report deficiencies and compliance issues identified 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 after receiving a survey that identifies deficiencies.
How to fill out cms-2567?
To fill out CMS-2567, providers must provide details about the deficiencies identified, describe the corrective actions taken, and submit the form to the appropriate CMS Regional Office.
What is the purpose of cms-2567?
The purpose of CMS-2567 is to ensure that healthcare facilities take corrective actions to address deficiencies and to comply with federal regulations and standards.
What information must be reported on cms-2567?
The information that must be reported on CMS-2567 includes details about the deficiency, the specific regulations violated, and the corrective actions planned or implemented.
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