PDF
Word
Form 3058-SM Admit / Discharge / Death Notice for Nursing, Icf / Mr, and Acute Facility Tracking Use - Nevada
What Is Form 3058-SM?
This is a legal form that was released by the Nevada Department of Health and Human Services - a government authority operating within Nevada. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 3058-SM?
A: Form 3058-SM is a document used for admitting, discharging, or reporting deaths in nursing, ICF/MR, and acute care facilities in Nevada.
Q: What is the purpose of Form 3058-SM?
A: The purpose of Form 3058-SM is to track admissions, discharges, and deaths in nursing, ICF/MR, and acute care facilities in Nevada.
Q: Who uses Form 3058-SM?
A: Nursing, ICF/MR, and acute care facilities in Nevada use Form 3058-SM for tracking admissions, discharges, and deaths.
Q: What information is included in Form 3058-SM?
A: Form 3058-SM includes information about the individual's admission, discharge, or death, such as date, time, location, and reason.
Q: Is Form 3058-SM specific to Nevada?
A: Yes, Form 3058-SM is specific to Nevada and is used by facilities in the state.
Q: Is Form 3058-SM mandatory for all facilities in Nevada?
A: Yes, Form 3058-SM is mandatory for all nursing, ICF/MR, and acute care facilities in Nevada.
Form Details:
- Released on August 1, 2003;
- The latest edition provided by the Nevada Department of Health and Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form 3058-SM by clicking the link below or browse more documents and templates provided by the Nevada Department of Health and Human Services.
