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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:02/19/2014FORM
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What is this visit was for?
This visit is for conducting an inspection of the facility.
Who is required to file this visit was for?
The facility manager or owner is required to file this visit.
How to fill out this visit was for?
The visit should be filled out with the 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 that must be reported includes observations, recommendations, and corrective actions.
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