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01/24/2022PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICESOMB NO. 0938039STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/CLIA(X2) MULTIPLE CONSTRUCTIONAND
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The complaint in00366779 substantiated federal refers to a formal allegation that has been verified or confirmed by federal authorities regarding a violation of laws or regulations.
Individuals, organizations, or entities that believe they have been affected by a violation of federal law or policy are required to file the complaint.
To fill out the complaint, you should provide detailed information about the alleged violation, including your contact information, a description of the incident, and any supporting evidence.
The purpose of the complaint is to initiate an investigation into the alleged violation and to hold responsible parties accountable for their actions.
The complaint must report information such as the names of involved parties, dates and locations of the events, specific details of the alleged violation, and any relevant documentation.
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