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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:15G48210/12/2016FORM
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What is this visit was for?
This visit was for a routine inspection of the facility.
Who is required to file this visit was for?
The manager of the facility is required to file this visit.
How to fill out this visit was for?
You can fill out this visit by providing accurate information about the inspection findings.
What is the purpose of this visit was for?
The purpose of this visit is to ensure compliance with safety regulations.
What information must be reported on this visit was for?
You must report any violations found during the inspection.
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