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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES11/16/2011FORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES OMB NO. 09380391STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION
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Take a blank f0000 form
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The visit was related to a routine check.
The company's compliance officer is responsible for filing f0000.
F0000 can be filled out online through the designated portal, following the instructions provided.
The purpose of f0000 is to document the details of the visit for compliance purposes.
Information such as date of visit, visitors' names, purpose of visit, and duration must be reported on f0000.
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