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PRINTED: 12/1/2019 FORM APPROVED OMB NO. 09380391DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA

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How to fill out omb no 0938-0391 form

1. To fill out omb no 0938-0391 form, follow these steps:
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Who needs omb no 0938-0391 form?

1. OMB No 0938-0391 form may be needed by individuals or entities who are required to provide certain information to the Office of Management and Budget (OMB) in accordance with specific regulations or procedures.
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What is omb no 0938-0391 form?

The omb no 0938-0391 form is a form used for reporting financial information to the Office of Management and Budget (OMB).

Who is required to file omb no 0938-0391 form?

Health care providers and institutions that receive federal funding are required to file the omb no 0938-0391 form.

How to fill out omb no 0938-0391 form?

The omb no 0938-0391 form can be filled out electronically or by hand, following the instructions provided by OMB.

What is the purpose of omb no 0938-0391 form?

The purpose of the omb no 0938-0391 form is to track and analyze how federal funds are being used in the healthcare sector.

What information must be reported on omb no 0938-0391 form?

The omb no 0938-0391 form requires reporting of financial data, patient information, and services provided by the healthcare provider.