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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:15573404/10/2014FORM
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This visit was for a routine inspection.
The designated supervisor or responsible party is required to file this visit.
To fill out this visit, the supervisor must provide details on the inspection findings and any corrective actions taken.
The purpose of this visit was to ensure compliance with safety regulations and standards.
Information such as date of inspection, areas inspected, findings, corrective actions, and signatures must be reported on this visit.
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