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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:15509503/19/2015FORM
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Survey date 030215 refers to the specific date on which a survey is conducted.
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Participants must report specific details and data requested in the survey form on survey date 030215.
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