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PRINTED: 03/22/2018 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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Please note that the specific eligibility criteria and services provided by Chase City Health may vary, so it is advisable to consult the official Chase City Health website or contact their representative for more detailed information.

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Chase City Health and is a form that businesses and individuals in Chase City must file to report their annual health information.

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The information that must be reported on Chase City Health and includes basic health information, current health conditions, and any relevant medical history.

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