Shown below are the details for the item you selected from the list.
Form # |
CMS 671 |
Form Title |
LTC Facility Application for Medicare/Medicaid |
Revision Date |
12/01/2002 |
O.M.B. # |
EXMPT |
O.M.B. Expiration Date |
N/A |
CMS Manual |
N/A |
Special Instructions |
N/A |
| Downloads | CMS 671 (367KB)
| Related Links Inside CMS | There are no Related Links Inside CMS
| Related Links Outside CMS | ![External Linking Policy](https://webarchive.library.unt.edu/eot2008/20090116175952im_/http://www.cms.hhs.gov/images/disclaimer.gif) | There are no Related Links Outside CMS
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Last Modified Date : 10/20/2008
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