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PRINTED: 12/30/2022 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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Begin by clearly stating your personal information such as name, address, phone number, and email.
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The complaint in00392725 - substantiated refers to a complaint that has been found to have merit or validity.
The individual or organization experiencing the issue or concern is required to file a complaint in00392725 - substantiated.
To fill out a complaint in00392725 - substantiated, one must provide detailed information about the issue, including dates, times, and any evidence supporting the claim.
The purpose of a complaint in00392725 - substantiated is to address and resolve a specific issue or concern that has been identified.
The complaint in00392725 - substantiated must include specific details about the issue or concern, any relevant evidence, and contact information for the individual or organization filing the complaint.
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