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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:15000907/31/2018FORM

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What is this visit was for?

This visit is for a routine inspection of the facilities.

Who is required to file this visit was for?

The facility manager or authorized personnel is required to file this visit.

How to fill out this visit was for?

The visit should be filled out with accurate information and any required documentation.

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?

Information such as maintenance logs, safety procedures, and inventory may need to be reported.

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