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PRINTED: 01/15/2013 FORM APPROVED DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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2013 BATESVILLE IN00121681 disclosable CFR Subpart payor IAC LSC Marlatt SNF NF X3 X4 CMS-2567 ZI3911 X1 CLIA OMB X5 HWY X2 X6 Substantiated denotes referenced DEFICIENCIES REGULATORY RN requisite PREFIX

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