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(use with Form CMS-672) GENERAL INSTRUCTIONS: THIS FORM IS TO BE COMPLETED BY THE FACILITY AND REPRESENTS THE CURRENT CONDITION OF RESIDENTS AT. THE TIME OF COMPLETION.
What is CMS Matrix?
The Matrix is used to identify pertinent care categories for: 1) newly admitted residents in the last 30 days who are still residing in the facility, and 2) all other residents. The facility completes the resident name, resident room number and columns 121, which are described in detail below.
What is CMS form 671?
What Is Form CMS-671? Form CMS-671, Long-Term Care Facility Application for Medicare and Medicaid, is a document developed for nursing facilities that are supposed to be filed during standard or extended health surveys.
What is a CMS 802 form?
The Roster/Sample Matrix form (CMS-802 ) is used by the facility to list all current residents (including residents on bedhold) and to note pertinent care categories. The facility completes the following: resident name, resident room, and columns 635, which are described below.
What is a CMS 802 form?
The Roster/Sample Matrix form (CMS-802 ) is used by the facility to list all current residents (including residents on bedhold) and to note pertinent care categories. The facility completes the following: resident name, resident room, and columns 635, which are described below.
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