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This document outlines deficiencies found during a survey of West Bend Nursing and Rehabilitation located in South Bend, IN. It includes complaints investigated, corrective actions taken, and plans for future compliance to ensure residents are free from abuse and neglect. It also denotes the facility\'s requests and responses related to the investigation of specified complaints.

How to fill out cms-2567

How to fill out cms-2567

1. Obtain the CMS-2567 form from the official CMS website or your local Medicare office.
2. Gather necessary information such as facility details and the specific compliance issues being reported.
3. Fill in the facility's name, address, and identifying numbers at the top of the form.
4. Provide a summary of the findings or issues, detailing each non-compliance instance under the relevant sections.
5. Include specific citations from regulations or guidelines that support each finding.
6. Document corrective actions taken or proposed in response to findings.
7. Review the completed form for accuracy and completeness.
8. Submit the form to the appropriate CMS regional office as instructed.

Who needs cms-2567?

1. Healthcare facilities undergoing inspections or audits by CMS.
2. Organizations required to report compliance issues or findings.
3. Facilities that need to document their adherence to Medicare and Medicaid standards.

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What is cms-2567?

CMS-2567 is a form used by the Centers for Medicare and Medicaid Services (CMS) to report deficiencies found during surveys of health care providers.

Who is required to file cms-2567?

Health care facilities that participate in Medicare or Medicaid programs are required to file CMS-2567 if deficiencies are found during inspections.

How to fill out cms-2567?

To fill out CMS-2567, facilities must provide detailed information about the deficiencies, including descriptions, the nature of the issue, and if applicable, the corrective actions taken.

What is the purpose of cms-2567?

The purpose of CMS-2567 is to document any deficiencies in compliance with federal health care standards and to ensure accountability in the quality of care provided.

What information must be reported on cms-2567?

The CMS-2567 must report information such as the facility name, survey dates, specific deficiencies found, and the required corrective actions to address those deficiencies.