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05/15/2019PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION

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What is this visit was for?

This visit was for a routine inspection of the facility.

Who is required to file this visit was for?

The manager of the facility is required to file this visit.

How to fill out this visit was for?

The visit report must be completed with details of the inspection findings.

What is the purpose of this visit was for?

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

What information must be reported on this visit was for?

All violations found during the inspection must be reported.

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