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PRINTED: 10/14/2019 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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Any individual or organization involved in a complaint or investigation process may need to fill out a complaint investigation survey.

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What is complaint investigation survey was?

The complaint investigation survey is a form used to gather feedback from individuals who have filed complaints.

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Any individual who has filed a complaint may be required to fill out a complaint investigation survey.

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To fill out the complaint investigation survey, individuals must respond to the questions asked and provide accurate information related to their complaint.

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The purpose of the complaint investigation survey is to gather feedback and information related to the complaints filed in order to improve the investigation process.

What information must be reported on complaint investigation survey was?

The complaint investigation survey may require individuals to report details about the nature of their complaint, the parties involved, and any actions taken by the investigators.

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