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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:15502603/06/2014FORM

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What is this visit was for?

This visit was for a routine inspection of the facilities.

Who is required to file this visit was for?

The facility manager is required to file this visit.

How to fill out this visit was for?

The visit report must be filled out electronically and submitted online.

What is the purpose of this visit was for?

The purpose of this visit is to ensure compliance with regulations and standards.

What information must be reported on this visit was for?

The visit report must include details of any findings or violations discovered during the inspection.

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