Form 3724-2025

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4.9 out of 5

59 votes

The document is a provider letter from Adelaide Horn, dated May 1, 2006, addressing Intermediate Care Facilities for Persons with Mental Retardation or a Related Condition. It outlines changes in the processing of CMS Form-2567 and DADS Form-3724 when multiple survey activities occur concurrently. Key points include the issuance of separate forms for re-cited and new deficiencies during follow-up visits, inclusion of specific comments in the forms regarding multiple citations, and updates to regulations affecting licensing violations.

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Click ‘Get Form’ to open it in the editor.
Begin by reviewing the Initial Comment section, which provides essential information about the survey activities and any deficiencies noted.
Fill in the required fields, including your facility's name and address. Ensure accuracy to avoid processing delays.
In the Deficiencies section, clearly indicate any cited practices. If there are multiple citations, ensure each is documented separately as per the guidelines provided.
Review all entries for completeness and accuracy before submitting. Utilize our platform’s editing tools to make any necessary adjustments easily.

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