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PRINTED: 01/23/2023 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 in00399283 has been validated and found to have sufficient evidence to support the claims made.
The individual or entity affected by the issue addressed in the complaint is required to file it.
To fill out the complaint, follow the provided guidelines, ensuring to include all necessary information and evidence supporting your claim.
The purpose is to formally address and resolve issues related to the allegations that were found to have merit.
The report must include details of the allegations, supporting evidence, and any relevant documentation.
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