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PRINTED: 01/20/2021 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 this visit was for?
This visit was for a routine inspection.
Who is required to file this visit was for?
The designated personnel on site are required to file this visit.
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What is the purpose of this visit was for?
The purpose of this visit is to ensure compliance with regulations and standards.
What information must be reported on this visit was for?
All findings, observations, and actions taken during the visit must be reported.
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