Any deficiency
statement ending with an asterisk (*) denotes a deficiency
which the institution may be excused from correcting providing
it is determined that other safeguards provide sufficient
protection to the patients. (See reverse for further
instructions.) Except for nursing homes, the findings stated
above are disclosable 90 days following the date of survey
whether or not a plan of correction is provided. For nursing
homes, the above findings and plans of correction are
disclosable 14 days following the date these documents are made
available to the facility. If deficiencies are cited, an
approved plan of correction is requisite to continued program
participation
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER
REPRESENTATIVE'S SIGNATURE