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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:15571610/17/2017FORM

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What is this visit was for?

This visit was for a routine inspection of the facility.

Who is required to file this visit was for?

The manager or owner of the facility is required to file this visit.

How to fill out this visit was for?

The visit can be filled out online through the designated portal provided by the regulatory agency.

What is the purpose of this visit was for?

The purpose of this visit was to ensure compliance with regulations and safety standards.

What information must be reported on this visit was for?

Information such as employee training records, sanitation practices, and equipment maintenance logs must be reported.

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