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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:15764112/14/2012FORM

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What is this visit was for?

This visit is for a routine inspection.

Who is required to file this visit was for?

The company's compliance officer is required to file this visit.

How to fill out this visit was for?

The visit must be documented in the company's compliance log 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 regulations and standards.

What information must be reported on this visit was for?

The information reported must include the date of the visit, the inspector's name, the findings, and any action taken to address non-compliance.

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