Get Shellae Dietrich, Program Specialist Kathryn Serie, Hfe Ne Ii

Filling out the Shellae Dietrich, Program Specialist Kathryn Serie, HFE NE II online form is essential for ensuring compliance with Medicare and Medicaid certification standards. This guide will provide you with clear, step-by-step instructions to help you accurately complete the form.

Follow the steps to complete the online form accurately.

1. Click the ‘Get Form’ button to obtain the form and open it in your editor.
2. Begin by entering the Medicare/Medicaid provider number at the designated field, ensuring accuracy to avoid delays.
3. Fill in the state vendor or Medicaid number, as this is necessary for identification purposes. Double-check for any required formats.
4. Indicate the facility's name and address in the appropriate sections. Ensure all details are correct to maintain compliance.
5. Record the effective date of change of ownership and the date of survey in the relevant fields.
6. Select the accreditation status from the provided options, noting any applicable codes based on your facility's certification.
7. Detail the total number of certified beds and total facility beds as specified in the form. Ensure that this information reflects your latest records.
8. Provide comprehensive comments and remarks as necessary in the designated section on the form. Any additional documentation should be attached as instructed.
9. Review all entries for completeness and correctness before submitting the form.
10. Once you are confident that all information is accurate, you can save changes, download, print, or share the form as necessary.

Complete your documents online today to ensure compliance and facilitate smooth operations.