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PRINTED: 12/08/2015 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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It is a survey result document related to long-term care facilities.
The administrators or owners of the long-term care facilities are required to file it.
The document should be filled out by providing the required information accurately and completely.
The purpose is to report the survey results of long-term care facilities.
Information such as facility details, survey findings, and compliance measures.
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