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08/28/2024PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/CLIAAND PLAN OF CORRECTIONIDENTIFICATION
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Begin by identifying the relevant details of the complaint.
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Complete the front page of the investigation form with basic information.
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Individuals or parties involved in a formal complaint process that requires thorough investigation.
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The investigation of complaint IN00440268 is a formal process to examine and assess the issues raised in the complaint documented with that identifier.
Typically, the individual or organization that has made the complaint is responsible for filing the investigation request for complaint IN00440268.
To fill out the investigation of complaint IN00440268, complete the designated form with accurate information regarding the complaint, the parties involved, and any supporting documentation required.
The purpose of the investigation of complaint IN00440268 is to determine the validity of the claims made and to ensure appropriate corrective actions are taken if warranted.
Key information to be reported includes the nature of the complaint, involved parties, dates of incidents, and any evidence or documentation supporting the complaint.
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