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PRINTED: 08/04/2021 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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Form investigation of complaint is a formal document used to report and document complaints or grievances.
Any individual or entity who wishes to report a complaint or grievance is required to file form investigation of complaint.
Form investigation of complaint can be filled out by providing detailed information about the complaint, including dates, names, and descriptions of the issue.
The purpose of form investigation of complaint is to ensure that complaints or grievances are properly documented and addressed.
Information such as the name of the complainant, date of the complaint, description of the issue, and any supporting documentation must be reported on form investigation of complaint.
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