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Nursing Home Forms & Publications
Administrative Links for Nursing Homes
BHS E-Mail Registration Form
Online Submission
Certificate of Appointment for Authorized Representative
(BHS-NHM-125)
Change of Administrator or Director of Nursing
(BHS-NHM-110)
Facility Information Sheet
(BHS-NHM-271)
Facility Request to Accept Evidence of Deficiency Correction (In Lieu of a Revisit)
(BHS-OPS-325)
Fill-in Form
Licensure and Certification Forms & Documents for Nursing Homes
Plan of Correction Instructions
(Rev. 9-11-08)
Quarterly Nursing Staff Report and Instructions
Fill-In Form
Request for Change in Number of Certified SNF and/or NF Beds
(BHS-NHM-102)
Fill-In Form
Resident Bed Rail Consent Form
(BHS-NHM-104)
Fill-In Form
Surety Bond for Patient Trust Funds Held by a Nursing Home
(BHS-NHM-126)
Complaints, Incidents and Investigation Links
Abuse and Neglect Investigation Guide
(Rev. 9/07)
Abuse Elements Guideline
(Rev. 7/08)
A Citizen's Guide to Filing a Complaint Against a Health Care Facility
(BHS-OPS-700)
BHS Health Facility Online Complaint Form
On-Line Submission
Facility Incident Report - 24 Hours
(BHS-OPS-362)
Facility Incident Report - 24 Hours
(BHS-OPS-362)
Online Submission
Facility Investigation Report - 5 Working Days
(BHS-OPS-363)
PDF Format
Facility Investigation Report - 5 Working Days
(BHS-OPS-363) Word Format
Nursing Home Complaint Form
(BHS-OPS-361a, Rev. 10/03)
Resident Assistance Form
(Example and Instructions for Facilities Handling Complaints)
Resident/Patient Care Complaint Form (BHS-OPS-361)
Informal Deficiency Review Links
Informal Deficiency Review (IDR) Process
Informal Deficiency Review - Level 2
(BHS-108)
Informal Deficiency Review
(BHS-108e)
Fill-in Form
Involuntary Transfer or Discharge Links
Appeal of a Notice of an Involuntary Transfer or Discharge
(BHS-OPS-505)
Facility Involuntary Transfer/Discharge Plan Checklist
(BHS-OPS-512)
Guidance in the Preparation of a Notice of an Involuntary Transfer or Discharge
Notice of an Involuntary Transfer or Discharge
(BHS-OPS-502)
Nursing Home Closure Information
Michigan Operations Manual (MOM)
115136
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