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PRINTED: 05/08/2024 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 in00433196- no deficiencies refers to a formal report filed indicating that there are no deficiencies identified in the subject matter of the complaint.
Typically, an individual or entity who has an interest or is affected by the subject matter is required to file the complaint.
To fill out the complaint, one should provide relevant details, such as the subject of the complaint, any supporting documentation, and ensure all required fields are completed accurately.
The purpose of the complaint is to formally document that a review has shown no deficiencies and to affirm compliance with applicable standards or regulations.
Information that must be reported includes the complainant's details, the subject of the complaint, findings of the review, and an affirmation that no deficiencies were found.
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