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PRINTED: 02/22/2024 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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Complaint in00427134 refers to a formal grievance filed regarding a specific issue or violation.
Individuals or entities affected by the issue that the complaint addresses are required to file complaint in00427134.
To fill out complaint in00427134, complete the designated form with accurate details about the grievance, including necessary personal information and specifics of the complaint.
The purpose of complaint in00427134 is to formally bring an issue to the attention of the relevant authority for resolution or enforcement of regulations.
Information that must be reported on complaint in00427134 includes the complainant's details, a description of the issue, any relevant dates, and supporting evidence if available.
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