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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:15K07005/28/2015FORM
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What is this visit was for?
This visit is for inspection purposes.
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The form must be completed with detailed information about the inspection.
What is the purpose of this visit was for?
The purpose of this visit is to ensure compliance with regulations.
What information must be reported on this visit was for?
Details of the inspection findings and any corrective actions taken must be reported.
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