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PRINTED: 09/10/2021 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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Complaint in00361763 - unsubstantiated refers to a specific case or incident that has been reported but lacks evidence to support the claim.
The individual or organization who experienced or witnessed the incident is required to file the complaint in00361763 - unsubstantiated.
To fill out the complaint in00361763 - unsubstantiated, provide detailed information about the incident, any supporting evidence, and contact information.
The purpose of the complaint in00361763 - unsubstantiated is to document and address reported incidents even if they are lacking in evidence.
The complaint in00361763 - unsubstantiated must include details of the incident, dates, times, locations, individuals involved, and any relevant documentation.
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