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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:15525109/04/2015FORM
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What is this visit was for?
This visit is for a routine inspection by regulatory authorities.
Who is required to file this visit was for?
The owner or operator of the establishment is required to file this visit.
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The visit should be filled out accurately and completely using the provided form.
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?
Details of the inspection, any violations found, and corrective actions taken must be reported.
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