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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:15521810/15/2012FORM

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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 authorized representative of the organization or business is required to file this visit.

How to fill out this visit was for?

The visit report must be filled out with all relevant information and details about the inspection.

What is the purpose of this visit was for?

The purpose of this visit is to ensure compliance with regulations and standards.

What information must be reported on this visit was for?

All findings, observations, and corrective actions taken must be reported in the visit report.

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