August, 1999

Information Bulletin 99-23

Exhibits To Transmittal Number 10
State Operations Manual - Provider Certification


The purpose of this information bulletin is to provide you with hard copies of the exhibits in Transmittal 10 of the State Operations Manual which were not available at the time of the mailing of Information Bulletin 99-16 titled, "New Long Term Care Survey Protocols and Guidance to Surveyors - Appendix P."

Copies of the following exhibits were sent with the mailing of this information bulletin:

    Exhibit 265, Roster/Sample Matrix, HCFA-802

    Exhibit 266, Roster/Sample Matrix Provider Instructions, HCFA-802P

    Exhibit 267, Roster/Sample Matrix Surveyor Instructions, HCFA-802S

    Exhibit 268, Facility Characteristics

    Exhibit 269, Facility Quality Indicator Profile

    Exhibit 270, Resident Level Summary

    Exhibit 271, Quality Indicator Matrix

These exhibits will not be posted on the MDH web site due to the formatting of the documents.

If you have any questions regarding this information bulletin, please contact in writing:

Minnesota Department of Health
Health Regulation
Licensing and Certification Program
85 East Seventh Place, Suite 300
P.O. Box 64900
St. Paul, Minnesota 55164-0900

Updated Friday, February 20, 2015 at 04:02PM