The CMS-2567: Statement of Deficiencies Explained
Form CMS-2567 records survey deficiencies and provides the facility's Plan of Correction response area. This walkthrough explains the fields, how to read a finding, and where to find official records. The annotated worksheet is self-created, uses invented details, and is not the official form.
Two-column format
- Summary Statement of Deficiencies: the survey team's regulatory citation and evidence from observation, interview, and record review.
- Plan of Correction: the facility's cross-referenced response; it is not proof by itself that correction was implemented.
Self-created illustrative orientation worksheet
This page's visual aid is not a reproduction of CMS's form and contains no real resident, facility, or survey data. Use the official CMS-2567 PDF and CMS form information page for the current form and instructions.
Field walkthrough
- Provider ID and facility information: match the certified entity and survey location.
- ID prefix/tag: identify the federal requirement and read the full regulation.
- Summary Statement: separate survey evidence from the tag label and note scope/severity.
- Plan of Correction: look for affected-resident action, broader screening, systemic change, monitoring, and completion date.
- Completion date and signature: treat the date as the facility's allegation of completion to be verified under the survey process.
Finding survey records
Check Medicare Care Compare, the CMS Provider Data Catalog nursing-home datasets, the facility, and the applicable State Survey Agency contact directory. Access and release timing vary by provider, survey type, state, and release stage.
CMS's public-release guidance describes the official CMS-2567 as publicly releasable within 14 days after receipt by the provider, supplier, or laboratory for the applicable process. CMS's Nursing Home Enforcement FAQ describes an acceptable POC as due within 10 calendar days after receipt; confirm the date and instructions with the State Survey Agency.
Editorial note and sources
Owned by the POCDesk editorial team, an editorial publisher rather than a clinical or legal practice. Substantively updated September 16, 2026. Form revisions, release timing, survey records, and state access paths can change. This guide does not reproduce the official form, identify real resident or facility data, or determine whether a finding is current or corrected. Read CMS nursing-home enforcement and the CMS release policy memo for source context.
Explore POCDesk — Free Nursing Home Compliance Tools
- SNF Scorecard — look up any facility's inspection record
- Nursing Home Compare Tool — side-by-side comparisons
- Skilled Nursing Near Me — find facilities by city & state
- Best Nursing Homes by State — ranked by inspection results
- Survey Tracker — recent CMS survey activity
- F-Tag Reference Guide — every CMS deficiency tag
- Plan of Correction (POC) Complete Guide
- Free AI POC Generator
- Plan of Correction Examples
- CMS Survey Preparation Guide
- Practical SNF Answers
- SNF Compliance Guides
- What Is Skilled Nursing Care?
Official Sources
POCDesk analyzes official government data. Verify any facility's record or read the underlying regulations at these primary sources:
- Medicare.gov Care Compare — CMS's official nursing home comparison tool
- CMS Provider Data Catalog — the raw nursing home inspection & deficiency datasets
- CMS Nursing Home Certification & Compliance — enforcement policy and the Special Focus Facility program
- 42 CFR Part 483 (eCFR) — the federal requirements of participation behind every F-Tag
- National Long-Term Care Ombudsman Resource Center — free advocacy help for residents and families