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06/26/2023PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION
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The complaint in00409906-federalstate deficiencies refers to formal allegations made regarding failure to comply with federal or state regulations, identifying specific deficiencies in operations, practices, or reports.
Individuals or entities that identify failures to comply with federal or state regulations, which could include employees, stakeholders, or regulatory authorities, are generally required to file this complaint.
To fill out the complaint, download the required form from the relevant regulatory agency's website, provide detailed information about the deficiencies, include supporting documentation, and submit it through the designated filing method.
The purpose of the complaint is to formally notify regulatory authorities of non-compliance issues, enabling them to investigate and enforce adherence to federal or state regulations.
The complaint must include the name of the complainant, details of the entity or individual being reported, specific descriptions of the deficiencies, dates of occurrence, and any supporting evidence.
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