Your CMS-2567 statement of deficiencies, and what to do next

What the CMS-2567 is

Form CMS-2567, Statement of Deficiencies and Plan of Correction, lists each deficiency on the left side and leaves space for your plan of correction on the right. CMS's form instructions say the plan should describe the corrective action and the anticipated time of correction, and, if corrections are already done when the form is returned, the date completed.

Deadlines

CMS updated State Operations Manual Chapter 6 in January 2025 (QSO-25-13-CLIA), including changing the time for the state agency to send the CMS-2567 to a lab from 10 calendar days to 10 working days. On the lab side, CMS's model letter (Exhibit 111) asks the lab to return the form, dated and signed by the director, within 10 days of receipt. Always follow the date in the cover letter you actually received.

Plan of correction or allegation of compliance

SOM Chapter 6 covers both. A plan of correction (PoC) answers standard-level deficiencies. When condition-level deficiencies are cited, the process can involve an allegation of compliance (AoC) and possible sanctions. The state agency reviews the PoC or AoC, may conduct a revisit survey, and records results on Form CMS-2567B.

Writing a plan that gets accepted

• Answer every deficiency, keyed to its tag
• Say what was corrected for the specific instance and how you checked for others
• Name the systemic change: procedure, training, role, schedule
• Give a responsible person, a completion date, and how you will monitor
• Have the laboratory director sign

Our longer walkthrough is on soundlabconsult.com. If the 2567 involves PT, see our PT noncompliance page.

Frequently asked questions

What is a CMS-2567?

Form CMS-2567 is the Statement of Deficiencies and Plan of Correction. It lists survey findings and is where the lab writes its plan of correction.

How long do I have to respond to a 2567?

CMS's model letter asks for the signed form within 10 days of receipt. Follow the deadline in your cover letter.

Who signs the plan of correction?

CMS's model letter asks that the CMS-2567 be dated and signed by the laboratory director.

What happens after I submit the plan?

The state agency reviews the PoC or AoC and may perform a revisit survey, recorded on Form CMS-2567B, per SOM Chapter 6.

Is a 2567 public?

CMS makes survey information available through QCOR. Check your lab's entry there.