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PRINTED: 04/22/2024 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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The complaint in00432279 refers to a formal notification or assertion of grievances related to a specific issue, indicating that there are no deficiencies and that the matter has been reviewed thoroughly.
Individuals or entities who have been directly affected by the issue represented in complaint in00432279 are required to file the complaint.
To fill out the complaint, individuals should provide relevant information including their details, the nature of the complaint, and any supporting documentation as required by the governing body.
The purpose of the complaint is to formally address concerns and ensure that issues are brought to attention without noting any deficiencies, thereby reiterating compliance or satisfaction with current standards.
The complaint should include personal identification details, the specifics of the complaint, any relevant dates, and any evidence or documentation that supports the claim.
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