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PRINTED: 04/20/2022 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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A complaint survey is a form used to report feedback or issues with a service or product.
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The purpose of a complaint survey is to gather feedback from customers and improve services or products.
Information such as the nature of the complaint, date and time of occurrence, and any relevant details must be reported on a complaint survey.
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