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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:15550805/24/2022FORM
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Obtain the complaint number 00377495.
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Gather all relevant information and evidence related to the complaint.
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04
Provide specific details of the incident, including dates, times, and individuals involved.
05
Submit the completed investigation form to the appropriate department or individual responsible for handling complaints.

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Individuals or entities who have filed or are affected by complaint number 00377495.
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03
Any other party involved in the complaint resolution process.
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Investigation of complaint in 00377495 is the process of looking into a reported issue or problem to gather information, analyze facts, and come to a resolution.
The individual or entity who received the complaint or is designated to handle complaints is required to file the investigation of complaint in 00377495.
The investigation of complaint in 00377495 should be filled out by providing details of the complaint, steps taken to investigate, findings, and resolutions or actions taken.
The purpose of investigation of complaint in 00377495 is to address the reported issue or problem, determine the root cause, and implement corrective actions to prevent future occurrences.
The investigation of complaint in 00377495 must include details of the complaint, individuals involved, investigation steps taken, findings, conclusions, and any corrective actions or resolutions.
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