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PRINTED: 11/25/2019 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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Preparedness survey is conducted on the readiness and capacity of individuals, organizations, or communities to respond to emergencies or disasters.

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Information such as emergency contact information, evacuation plans, medical needs, and supplies must be reported on the survey.

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