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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:15581511/17/2014FORM

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What is this visit was for?

This visit was for a routine inspection.

Who is required to file this visit was for?

The designated site supervisor is required to file this visit.

How to fill out this visit was for?

The visit report form must be completed accurately with all necessary details.

What is the purpose of this visit was for?

The purpose of this visit was to ensure compliance with safety regulations.

What information must be reported on this visit was for?

The information that must be reported includes any safety hazards observed, corrective actions taken, and recommendations for improvement.

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