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PRINTED: 06/01/2023 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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Gather all necessary information related to the complaint.
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Review company policies and guidelines for handling complaints.
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An unannounced complaint investigation is an investigation initiated without prior notice to the subject of the complaint.
Any individual or organization who has knowledge of a potential violation or misconduct that requires investigation.
The unannounced complaint investigation should be filled out by providing detailed information about the alleged violation or misconduct, as well as any supporting evidence.
The purpose of an unannounced complaint investigation is to uncover any violations or misconduct and take appropriate action to address them.
The unannounced complaint investigation must include details about the complainant, the subject of the complaint, the alleged violation, and any supporting evidence.
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