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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:15008207/03/2019FORM
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This visit is for conducting an inspection of the facility.
The facility manager or owner is required to file this visit.
The visit should be filled out with accurate and detailed information about the inspection.
The purpose of this visit is to ensure compliance with regulations and standards.
The report must include findings, recommendations, and any corrective actions taken.
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