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PRINTED: 07/24/2019 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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What is form investigation of complaint?

Form investigation of complaint is a document used to report complaints and request investigations into alleged violations.

Who is required to file form investigation of complaint?

Any individual or organization that has a complaint or allegation of violation is required to file form investigation of complaint.

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Form investigation of complaint can be filled out online or in hard copy by providing details of the complaint, including dates, names, and a description of the alleged violation.

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The purpose of form investigation of complaint is to initiate an investigation into alleged violations and address complaints effectively.

What information must be reported on form investigation of complaint?

Form investigation of complaint requires details of the complaint, such as nature of the violation, parties involved, evidence, and any supporting documents.

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