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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:15008410/05/2016FORM
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What is this visit was for?
This visit is for conducting an inspection.
Who is required to file this visit was for?
The assigned inspector is required to file this visit.
How to fill out this visit was for?
The visit report must be filled out accurately and completely.
What is the purpose of this visit was for?
The purpose of this visit is to ensure compliance with regulations.
What information must be reported on this visit was for?
All findings and observations from the inspection must be reported.
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