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PRINTED: 03/27/2013 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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The complaint in00126140 - unsubstantiated refers to a report or allegation that lacks evidence or proof.
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To fill out the complaint in00126140 - unsubstantiated, one must provide detailed information about the alleged incident and any supporting evidence.
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The purpose of the complaint in00126140 - unsubstantiated is to report an alleged incident that lacks evidence for further investigation.
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The complaint in00126140 - unsubstantiated must include details of the alleged incident, names of individuals involved, dates, and any supporting evidence.
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