DEPARTMENT OF HEALTH AND HUMAN SERVICES Form …
DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES
Form Approved OMB No. 0938-0842
INPATIENT REHABILITATION FACILITY ? PATIENT ASSESSMENT INSTRUMENT
Form CMS-10036 (01/06)
1
DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES
INPATIENT REHABILITATION FACILITY ? PATIENT ASSESSMENT INSTRUMENT
Form CMS-10036 (01/06)
2
DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES
INPATIENT REHABILITATION FACILITY ? PATIENT ASSESSMENT INSTRUMENT
Form CMS-10036 (01/06)
3
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