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PRINTED DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE MEDICAID SERVICES STATEMENT OF DEFICIENCIES X1 PROVIDER/SUPPLIER/CLIA AND PLAN OF CORRECTION IDENTIFICATION NUMBER 15G693 05/18/2012 FORM APPROVED OMB NO. The 3/1/12 level indicated the client s / level was at 108. 7 H high as the lab indicated a normal range of 50 to 100. LPN 1 did not provide any additional documentation and/or information in regard to the high level.. An IDT meeting will be held regarding Client A s...

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