Get Maria Thoma, Hfe Neii Colleen B. Leach, Program Specialist 09/11 ...

This guide provides step-by-step instructions on how to fill out the Maria Thoma, HFE NEII Colleen B. Leach, Program Specialist 09/11 ... form online. Designed for users of all skill levels, this guide offers clear and concise directions to ensure your form is accurately completed.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access and open the form you're required to fill out.
2. Begin by entering the Medicare/Medicaid provider number in the designated field at the top of the form.
3. Fill in the name and address of the facility in the appropriate section, ensuring all details are accurate.
4. Indicate the state vendor or Medicaid number as requested, ensuring that you double-check for any typographical errors.
5. Provide the effective date for the change of ownership and date of the most recent survey.
6. Complete the certification details for the facility including total beds and certified beds.
7. Review any required remarks or approvals noted on the form to ensure compliance with all requirements.
8. Once all sections are filled out, review the entire form for accuracy and completeness.
9. Save your changes, and consider downloading or printing the form for your records if needed.

Complete your forms online confidently today to ensure swift processing.