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02/19/2018PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION
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This visit is for conducting a regulatory inspection.
The business owner or person in charge of the facility is required to file this visit.
The visit should be filled out accurately and truthfully, providing all required information.
The purpose of this visit is to ensure compliance with regulations and standards.
Information such as date of visit, inspector's name, findings, and any corrective actions taken must be reported.
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