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Government / Limb restraint / Physical restraint / Medicare / Seclusion


DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Form Approved OMB No[removed]
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Document Date: 2014-09-09 14:31:24


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File Size: 46,74 KB

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Facility

Hospital Name CCN Address City State Person Filing / /

MedicalTreatment

Physical Restraint / /

Organization

DEPARTMENT OF HEALTH AND HUMAN SERVICES / MEDICARE / /

Product

Forced Medication / /

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