VA528-15-R-0410 A00002 CONTRACT NURSING HOME EXCLUSION REVIEW.DOC

Published: 02/18/2016

Description

Contract Nursing Home Exclusion Review Name of Nursing Home: Address: City, State & Zip: Six Digit Provider Number: VAMC: Date of Paper Review/Survey: Date of On-site Review/Survey: Contract Nursing Homes are to be excluded when four of the seven fac...

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