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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:15584509/29/2017FORM
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What is this visit was for?
This visit is for conducting a routine inspection of the premises.
Who is required to file this visit was for?
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To fill out this visit, the owner or manager must provide relevant information about the premises and any findings from the inspection.
What is the purpose of this visit was for?
The purpose of this visit is to ensure compliance with safety and health regulations.
What information must be reported on this visit was for?
Information such as maintenance records, safety procedures, and any violations found during the inspection must be reported.
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