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Printed: 06/17/2024 Form Approved OMB No. 09380391Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA
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The Jackson Memorial Long Term refers to a specific reporting form that is used for the purpose of documenting long-term care and services provided to individuals.
Entities and individuals who provide long-term care services or receive funding for such services must file the Jackson Memorial Long Term.
To fill out the Jackson Memorial Long Term, you need to gather necessary documents and information related to long-term care services, follow the form's instructions carefully, and ensure all required fields are completed accurately.
The purpose of the Jackson Memorial Long Term is to ensure accountability and transparency in the reporting of long-term care services and to facilitate the assessment of such services.
Information that must be reported includes the type of services provided, duration of care, patient demographics, funding sources, and any relevant outcomes.
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