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PRINTED: 04/16/2019 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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How to fill out facility was found in
How to fill out facility was found in
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Obtain the facility registration form from the relevant authority.
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Fill out the form with accurate and up-to-date information about the facility.
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Provide all requested details including facility name, address, contact information, type of facility, and any additional required information.
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Review the completed form for any errors or missing information.
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Any individual or organization that owns or operates a facility that requires registration or licensing.
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What is facility was found in?
The facility was found in refers to the location or place where the facility is situated.
Who is required to file facility was found in?
The entity or organization responsible for the facility is required to file where the facility was found in.
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To fill out where the facility was found in, provide the exact address or coordinates of the facility location.
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