Microsoft Word - 23XX6677_R0206.doc
If pending, please indicate the date of survey or application date: ____/____/____ AAAHC Accreditation Yes No CHAP Accreditation Yes No AASM Accreditation Yes No JCAHO Accreditation Yes No Other:_____ Were there any deficiencies from your last survey? Yes No . If so, please attach an explanation and your action plan to address recommendations. ... ................
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