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PRINTED: 03/22/2018 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 survey was conducted from?

A survey was conducted from a random sample of households.

Who is required to file survey was conducted from?

All adults aged 18 and over are required to file the survey.

How to fill out survey was conducted from?

The survey can be filled out online or through a paper form sent to households.

What is the purpose of survey was conducted from?

The purpose of the survey is to gather information on household demographics and preferences.

What information must be reported on survey was conducted from?

Information such as age, gender, income, and household size must be reported on the survey.

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