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PRINTED: 05/28/2019 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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Printed 0928 department of refers to a specific tax form or document used by a department for reporting financial information.
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Reported information typically includes income details, deductions, credits, and other relevant financial data as required by the department.
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