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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:15G03611/16/2015FORM
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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 or manager on duty is required to file this visit.
How to fill out this visit was for?
The visit must be filled out using the designated form and all relevant information must be included.
What is the purpose of this visit was for?
The purpose of this visit is to ensure compliance with safety regulations and standards.
What information must be reported on this visit was for?
The information that must be reported includes date and time of visit, areas inspected, findings, corrective actions taken, and signatures of both the inspector and the supervisor.
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