CMS-10455 Screenshot
(CMS-10455) 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                        ⚠️ Notice: This form may be outdated.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 | 2021-01-23 |