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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:15000902/15/2017FORM
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What is this visit was for?
This visit is for inspection purposes.
Who is required to file this visit was for?
The designated individual responsible for the premises must file this visit.
How to fill out this visit was for?
The visit must be documented with all relevant information and findings.
What is the purpose of this visit was for?
The purpose of this visit is to ensure compliance and safety standards are met.
What information must be reported on this visit was for?
All observations, recommendations, and any corrective actions taken must be reported.
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