Louisiana Department of Health & Hospitals | Bruce Greenstein, Secretary
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Hospital Off-Site Application Packet
Tuesday, June 17, 2008 |
Contact:
225.342.0138
Instructions and forms to apply for hospital off-site campuses.
Plan Review
Related Items
Cover Sheet for Off-Sites
CMS Letter - Prioritizing Initial Medicare Surveys
S&C 08-03 MEMO Initial Surveys for New Medicare Providers
Q&A About Completing the Off-Site Campus Application
Instructions for Submitting Hospital Off-Site Packet
Checklist for Hospital Off-Site Campuses
Hospital License Application
Questionnaire for a Hospital's Off-Site Campus
Worksheet for a Currently Licensed and Remote Hospital
Worksheet for Hospital Beds & Rooms
Instructions for Completing the Attestation Form
Attestation Letter
Public Health Application
Plan Review
Notification of Co-Located Status
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