Section He-E 807.02 - Surveys and Notification of Non-compliance(a) Surveys shall be conducted on NFs pursuant to 42 CFR Part 488 to determine compliance with the conditions of participation in the medicaid program as described in 42 CFR 483 Subpart B.(b) A facility not in compliance shall be notified in writing, within 10 working days after the last day of the survey, on Form CMS-2567, "Statement of Deficiencies" of the following: (1) The initial findings of the survey, that is, whether the facility was found to be in compliance or not;(2) The specific deficiency(ies) found, if the facility was not in compliance;(3) The specific requirements that must be met to be in compliance and to correct the deficiency; and(4) The specific evidence found during the survey which led to the finding of the deficiency.(c) The NF shall be notified in writing via a letter attached to the Form CMS-2567 of the: (1) Deficiency(ies) and the nature of the non-compliance found at the time of the survey, if any;(2) Remedy or remedies to be imposed based on the survey conducted pursuant to 42 CFR 488.406(a) and (b) , if any;(3) Effective date of the remedy or remedies;(4) Opportunity for an informal dispute resolution process as described in He-E 807.13 if the NF disagrees with the cited deficiency (ies) in the survey;(5) Name, address and telephone number of a contact person to request an informal dispute resolution hearing; and(6) The NF's right to request an administrative appeal pursuant to He-E 807.14, if applicable.(d) In the case of the remedy of a civil money penalty, the notice in (c) above shall also include the information listed in He-E 807.09(b) .N.H. Admin. Code § He-E 807.02