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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:15G79702/17/2021FORM

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Start by entering the date in the 'Month' field. The format should be MM (e.g., 01 for January).

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Move on to the 'Day' field and enter the day of the month. The format should be DD (e.g., 03 for the 3rd of the month).

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Lastly, input the four-digit 'Year' in the appropriate field (e.g., 2022).

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What is dates of survey 111?

Dates of survey 111 refer to the specific time frame of a survey conducted for data collection purposes.

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Individuals or entities designated by the survey organizers are required to file dates of survey 111.

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Dates of survey 111 can be filled out by providing accurate dates and details related to the survey in the designated form.

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The purpose of dates of survey 111 is to track and record the timeline of the survey for organizational and analytical purposes.

What information must be reported on dates of survey 111?

Information such as the start date, end date, and any other relevant dates related to the survey must be reported on dates of survey 111.

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