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PRINTED: 12/30/2020
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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What is 1230 form approved?
The 1230 form approved is a document used for reporting financial information.
Who is required to file 1230 form approved?
Any individual or organization that meets the criteria set by the regulations.
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Fill out the form with accurate and up-to-date financial information following the instructions provided.
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The purpose of the form is to provide transparency and accountability in financial reporting.
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Information such as income, expenses, assets, and liabilities may need to be reported.
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