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Protecting, MaintainingandImprovingtheHealthofAllMinnesotans Electronically delivered December1,2020 Administrator MotherOfMercySeniorLiving 230ChurchAvenue,Box676 Albany,MN56307 RE: CCN:245339 CycleStartDate:October14,2020DearAdminis
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Gather all necessary information required for the form.
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Visit the Minnesota Department of Health website to access the form.
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Carefully read and fill out each section of the form, providing accurate and complete information.
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Submit the form as per the instructions provided by the Minnesota Department of Health.

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The form is a survey completed by the Minnesota Department of Health on November 3.
Healthcare providers and facilities in Minnesota.
The form can be filled out online or submitted by mail with the required information.
To collect data on healthcare providers and facilities in Minnesota.
Details on services provided, patient demographics, and healthcare trends.
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