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Major injury determination form iowa

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The facility shall submit this Form to the Physician Designee or Extender within 24 hours of when the injury occurred* A signed copy of this Form must be obtained by the facility from the physician designee or extender within 72 hours of the injury. If the physician designee or extender refuses to complete the Form or is unavailable for completion and signature the DIA Director or designee must be notified of the injury within one business day. facility in the resident s clinical record and the ...

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