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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:15133402/14/2017FORM
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What is this visit was for?
This visit was for a routine inspection.
Who is required to file this visit was for?
The supervisor of the department is required to file this visit.
How to fill out this visit was for?
You can fill out this visit by documenting all findings and observations during the inspection.
What is the purpose of this visit was for?
The purpose of this visit is to ensure compliance with regulations and guidelines.
What information must be reported on this visit was for?
All relevant details about the inspection and any corrective actions taken must be reported.
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