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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:15G54502/28/2012FORM

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Step 1: Go to the secureingov website

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Step 2: Login with your credentials

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Step 3: Navigate to the ISDH reports section

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Step 4: Fill out the required fields with the information from the printed report dated 11/17/2017

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Step 6: Submit the report securely

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