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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:15G56711/16/2017FORM
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What is this visit was for?
This visit is for conducting a compliance check on the facility.
Who is required to file this visit was for?
The facility manager or designated compliance officer is required to file this visit.
How to fill out this visit was for?
The visit report must be filled out accurately with all relevant information.
What is the purpose of this visit was for?
The purpose of this visit is to ensure that the facility is in compliance with regulations.
What information must be reported on this visit was for?
All findings, observations, and corrective actions must be reported on this visit.
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