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PRINTED: 05/23/2022 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION
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Form surveyor entered form is a document where a surveyor enters information related to a specific survey.
Surveyors or individuals performing survey work are required to file form surveyor entered form.
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The purpose of form surveyor entered form is to document and record the results of a survey for legal or regulatory purposes.
Information such as survey details, location, purpose, methodology, and results must be reported on form surveyor entered form.
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