Get Nc Dhsr Acls : Final Report Of Investigation Of A Resident Death - Ncdhhs

This guide provides clear, step-by-step instructions for completing the NC DHSR ACLS Final Report of Investigation of a Resident Death online. Designed for users with varying experience levels, this resource aims to facilitate the accurate and complete submission of this important document.

Follow the steps to successfully complete the form online.

1. Press the ‘Get Form’ button to access the document and open it in your editing tool.
2. Fill in the section labeled 'Investigation conducted by' by checking all applicable entities such as County DSS and DHSR ACLS.
3. Enter the 'Intake Number', 'License Number', 'County', 'Facility Name', and 'Address' in the provided fields to identify the facility and case.
4. Document the 'Date(s) and time(s) of visit(s)' made during the investigation, including the 'Investigation Closed Date' at the end of the investigation.
5. List all individuals who participated in the investigation under the 'Participants' section.
6. Select the appropriate conclusion regarding compliance with rules and regulations from 'Conclusion/Determinations'. If 'Non-compliance' was identified, refer to the attached corrective action report or statement of deficiencies.
7. If no compliance issues exist, provide detailed notes of the investigation in the 'Details of Investigation' section, including relevant observations or interviews.
8. Include any comments as needed in the 'Comments' section to add any additional context to the report.
9. Obtain the required signatures from both the investigator and the administrator/designee, and date these signatures appropriately.
10. Once all information is completed, you can save your changes, download the completed document, print it, or share it as required.

Complete your NC DHSR ACLS form online today to ensure timely submission and compliance.