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Home and CommunityBased Services (HUBS) 2021 Provider Quality Management Reassessment This form is required for entities enrolled to provide services in Section B under the following waivers/programs:
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Incomplete self-assessments will not be considered valid or complete.
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All individuals or entities who are required to submit self-assessments must ensure they are complete and accurate.
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Incomplete self-assessments should be reviewed carefully and all missing information should be provided before submission.
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All required information related to the assessment subject must be reported accurately.
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