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PRINTED: 12/12/2017 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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Form investigation of complaint is a formal document used to report and investigate complaints regarding misconduct or violations of policies within an organization.
Any individual who has knowledge of a complaint or believes a complaint needs to be investigated is required to file form investigation of complaint.
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The purpose of form investigation of complaint is to ensure that complaints are properly documented, investigated, and resolved in a fair and timely manner.
Information such as details of the complaint, names of individuals involved, dates and times of incidents, and any supporting evidence must be reported on form investigation of complaint.
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