Statement of Deficiencies, Plan of Correction and Allegation of

6130 - Statement of Deficiencies, Plan of Correction and Allegation of Compliance, Form CMS-2567 (Rev. 199, Issued: 01-17-20, Effective: 01-17-20, Implementation: 01-17-20) The Form CMS-2567 (Exhibit 7) serves several important functions. They are as follows: • Documents that specific deficiencies were found. If there are no citations, the surveyor(s) indicates this in the left-hand column of the Form CMS- 2567; • Documents the laboratory’s receipt of the deficiency notice; • Discloses to the public the laboratory’s deficiencies and what is being done to remedy them; • Provides an opportunity for the laboratory to refute survey findings and to furnish documentation that requirements are met; and • Documents the laboratory’s plans and time frames for correcting the deficiencies.