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PRINTED: 07/09/2024
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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What is form surveyor entered form?
Form surveyor entered form is a document used to record data collected by a surveyor during a survey.
Who is required to file form surveyor entered form?
The surveyor who conducted the survey is required to file form surveyor entered form.
How to fill out form surveyor entered form?
Form surveyor entered form should be filled out by providing accurate data collected during the survey.
What is the purpose of form surveyor entered form?
The purpose of form surveyor entered form is to document and report the information collected during a survey.
What information must be reported on form surveyor entered form?
Information such as survey results, location data, and any relevant observations must be reported on form surveyor entered form.
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