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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:15506111/24/2020FORM

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Start by entering your personal information at the top of the form. This includes your name, address, and contact information.

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Correction does not constitute refers to the act of amending or correcting an error without it being classified as a formal submission or new filing.

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The purpose is to ensure accurate reporting and record-keeping while avoiding the complications of formal new filings.

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You must report the specific errors being corrected, the correct data, and any relevant identifiers related to the original submission.

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