CMS-10455 Screenshot
Report of a Hospital Dealth Associated with Restraint or Seclusion
DRS screens 06142012
Hospital Restraint/Seclusion Death Report Worksheet
OMB: 0938-1210
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1210 can be found here:
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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | CMS |
File Modified | 0000-00-00 |
File Created | 2021-01-30 |