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PRINTED: 07/01/2019 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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Unsubstantiated intake nc00152750 refers to a report or claim that has not been proven to be true or valid.
The individual or entity who received the report or claim is required to file unsubstantiated intake nc00152750.
Unsubstantiated intake nc00152750 can be filled out by providing accurate and detailed information regarding the report or claim.
The purpose of unsubstantiated intake nc00152750 is to document and track reports or claims that have not been verified.
The information that must be reported on unsubstantiated intake nc00152750 includes details of the report or claim, any actions taken to verify it, and the outcome.
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