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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:15547412/07/2016FORM
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What is this visit was for?
This visit is for conducting a routine inspection of the premises.
Who is required to file this visit was for?
The business owner or designated representative is required to file this visit.
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The visit report should be filled out accurately and completely, detailing any observations or findings during the inspection.
What is the purpose of this visit was for?
The purpose of this visit is to ensure compliance with regulations and standards set by the governing body.
What information must be reported on this visit was for?
The report must include details of the inspection findings, any violations noted, corrective actions taken, and the date and time of the visit.
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