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PRINTED: 11/18/2020
FORM APPROVEDDivision of Health Service Regulation
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA
IDENTIFICATION NUMBER:(X2) MULTIPLE CONSTRUCTION
A.
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McGee-Hudson home is a form used for reporting property ownership and certain financial information.
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Information such as property details, ownership information, and financial interest in the property must be reported on McGee-Hudson home.
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