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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:15401407/15/2014FORM

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What is this visit was for?

This visit is for conducting an inspection of the premises.

Who is required to file this visit was for?

The appointed inspector is required to file this visit.

How to fill out this visit was for?

The visit should be filled out with all necessary information and observations.

What is the purpose of this visit was for?

The purpose of this visit is to ensure compliance with regulations and safety standards.

What information must be reported on this visit was for?

All findings, violations, and recommendations must be reported on this visit.

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