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PRINTED: 02/02/2024 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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The complaint in00426025-no deficiencies related pertains to a specific issue or case that has been filed, indicating no deficiencies or shortcomings have been identified.
Any individual or entity affected by the condition or situation leading to the complaint in00426025-no deficiencies related is typically required to file.
To fill out the complaint, the individual or entity should complete the designated form, providing all necessary information regarding the case and ensuring accuracy and clarity.
The purpose of the complaint is to formally document an issue, seek resolution, and ensure that the matter is addressed by the relevant authorities or organizations.
The information that must be reported includes details of the complainant, the nature of the complaint, dates, involved parties, and any relevant evidence supporting the claim.
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