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PRINTED: 07/28/2020 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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The complaint in00331700 - unsubstantiated refers to a situation where a formal grievance has been filed but lacks sufficient evidence or factual basis to support its claims.
Any individual or entity who believes that a violation has occurred or who has been adversely affected by the actions in question is required to file the complaint in00331700 - unsubstantiated.
To fill out the complaint in00331700 - unsubstantiated, one must complete a designated form that typically includes personal information, a detailed description of the complaint, and any relevant evidence or documentation.
The purpose of filing a complaint in00331700 - unsubstantiated is to formally alert the appropriate authorities or organizations about concerns regarding actions or practices that may require investigation or intervention.
The information that must be reported includes the complainant's contact details, the nature of the complaint, specifics about the incident, and any witness information or documentation related to the case.
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