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PRINTED: 12/15/2022
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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What is form recertification and state?
Form recertification and state is a process of renewing or updating a form with relevant information in order to remain compliant with state regulations.
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Individuals or entities specified by state laws or regulations are required to file form recertification and state.
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The purpose of form recertification and state is to ensure that the information on record is current and accurate for regulatory compliance.
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Form recertification and state may require reporting of personal or business information, financial details, and any other relevant data specified by state laws.
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