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PRINTED: 04/30/2014 FORM APPROVED DEPARTMENT 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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2013 2014 disclosable CLIA X6 OMB I5B711 X4 X2 X5 X1 X3 LSC CMS-2567 denotes referenced DEFICIENCIES REGULATORY unsubstantiated abbreviated requisite PREFIX safeguards asterisk continuation CORRECTIVE HEARTLAND PRECEDED KY MEDICARE MEDICAID cited

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