Form CMS-2567: Key Specifications
For the most accurate and compliant submission, it is essential to use the correct and most current version of the form. Below are the official specifications for Form CMS-2567:
- Issuing Authority: Centers for Medicare & Medicaid Services (CMS), U.S. Department of Health & Human Services
- Official Form Name: Statement of Deficiencies and Plan of Correction
- Current Edition: March 18, 2022
- Official Download Link: Form CMS-2567
How to Fill Out Form CMS-2567 with BaseStation
Our platform combines the official process with a streamlined, AI-driven workflow to ensure accuracy and efficiency.
Step 1: Create Your BaseStation Data CoversheetBegin by creating a centralized Data Coversheet within BaseStation. This feature allows you to input all of your facility's critical information a single time. Alternatively, you can use BaseStation's AI form-filler GPT on the ChatGPT marketplace to automatically extract and structure your data.
Step 2: Initiate AI AutofillOnce your Data Coversheet is complete, BaseStation’s AI populates the entirety of Form CMS-2567 with the correct information. This eliminates manual data entry, significantly reducing the risk of errors and saving valuable time.
Step 3: Assemble Required DocumentationBased on the deficiencies cited in your survey, you will need to assemble the appropriate documentation to support your plan of correction. While the specific documents will vary, they often include:
- Policy and procedure updates
- Staff training records
- Quality assurance audits
- Patient care records relevant to the cited deficiencies
Step 4: Conduct an AI-Powered AuditBefore submission, leverage BaseStation's AI-powered audit. This feature reviews the completed form for accuracy, completeness, and compliance with CMS guidelines, flagging any potential issues for your review.
Step 5: Final StepsAfter the AI audit is complete and you have reviewed the form, the final step is to sign and submit it to the appropriate regulatory body as instructed by the surveying agency.
Why Use BaseStation for Your Form CMS-2567?
In a regulatory environment where precision is non-negotiable, BaseStation provides a professional solution.
- Increase Efficiency: By automating the data entry process, BaseStation dramatically reduces the time and manual labor required to complete the form.
- Ensure Accuracy and Compliance: Our AI audit feature cross-references information and ensures adherence to official guidelines, minimizing the risk of data entry errors and subsequent compliance issues.
- Cost-Effective: Avoid the significant costs associated with errors, resubmissions, and potential penalties by ensuring your form is completed correctly the first time.
- Enhanced Security: BaseStation prioritizes data protection, employing robust security measures to safeguard your facility's sensitive information.
Frequently Asked Questions (FAQs) about Form CMS-2567
What is the purpose of completing the Statement of Deficiencies and Plan of Correction (CMS-2567) form?The form is used by the Centers for Medicare & Medicaid Services (CMS) to identify deficiencies in healthcare facilities and outline corrective actions.
What is the significance of the Prefix Identification Tag in the form?It is a unique identifier assigned to each deficiency to cross-reference the deficiency with the plan of correction.
What happens if a facility fails to provide a plan of correction for cited deficiencies?CMS may take enforcement action, such as denial of payment or termination of the provider agreement.
Who should sign and date the form and when should it be returned?The hospital's Administrator or designee should sign and date the form, and it should be returned to CMS no later than 30 days from the date of the inspection report.
Common Errors in Completing Form CMS-2567
Even minor mistakes on this form can lead to major compliance issues. Here are some of the most common errors and how BaseStation helps prevent them.
- The Mistake: Entering an incomplete or inaccurate "Date Survey Completed."
- BaseStation Solution: The BaseStation Data Coversheet ensures that this date, once entered, is consistently and accurately populated throughout the form, eliminating the possibility of manual entry errors.
- The Mistake: Failing to include a complete Facility Address, including city, state, and zip code.
- BaseStation Solution: Our system validates that the facility address is complete and formatted correctly, preventing incomplete submissions.
- The Mistake: Listing deficiencies without the full regulatory or Life Safety Code (LSC) identifying information.
- BaseStation Solution: BaseStation’s guided process and AI audit can be configured to check for the presence and correct formatting of these critical identifiers, ensuring each deficiency is properly documented.
- The Mistake: Failing to cross-reference each corrective action to the appropriate deficiency.
- BaseStation Solution: Our structured workflow ensures a clear and direct link between each cited deficiency and its corresponding plan of correction, maintaining the integrity of the document.
BaseStation's AI Compliance Audit
Our AI audit is a meticulous review system designed to ensure the highest level of accuracy and compliance. This feature scans the completed Form CMS-2567 for data integrity, completeness, and adherence to official guidelines. For this specific form, the AI audit performs checks such as:
- Verifying that the Provider/Supplier/CLIA Identification Number is correctly formatted.
- Ensuring the "Date Survey Completed" is present and in the correct MM/DD/YYYY format.
- Confirming that the "Name of Facility Surveyed" matches the full legal name.
- Validating that the Facility Address is complete and includes all required components.
- Checking that each corrective action is explicitly linked to a corresponding deficiency.
The Form CMS-2567 requires a level of precision that leaves no room for error. BaseStation provides the advanced tools necessary to meet this standard with confidence and efficiency.
To learn more about how BaseStation can streamline your document workflows, Explore BaseStation
