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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:15544802/06/2013FORM
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What is this visit was for?
This visit is for conducting a safety inspection at the facility.
Who is required to file this visit was for?
The facility manager is required to file this visit.
How to fill out this visit was for?
The visit report must be filled out accurately and completely with all relevant information.
What is the purpose of this visit was for?
The purpose of this visit is to ensure compliance with safety regulations and identify any potential hazards.
What information must be reported on this visit was for?
All findings from the safety inspection must be reported, along with any corrective actions taken.
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