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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES01/06/2012FORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES OMB NO. 09380391STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION
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Survey dates November 28 refers to the specific dates designated in November for conducting surveys or data collection.
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The information required to be reported on survey dates November 28 will vary depending on the nature and objectives of the survey.
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