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PRINTED: 04/12/2019 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 0516 form approved is a document used for reporting certain financial information to the relevant authorities.
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The purpose of the form is to collect specific financial information for regulatory or tax compliance purposes.
The form typically requires information such as income, expenses, assets, liabilities, and other financial details.
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