| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852538 | (X3) Date Survey Completed 10/10/2024 |
| Name of Provider or Supplier Jesse Jewell Dialysis | Street Address, City, State 1475 Jesse Jewell Pkwy Ne, Ste 110, Gainesville, GA | |
| For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency. | ||
| (X4) ID Prefix Tag | Summary Statement of Deficiencies
(Each deficiency should be preceded by full regulatory or LSC identifying information) |
| V0000 | {CORE} A Recertification Survey was conducted at Jesse Jewell Dialysis from October 8, 2024 through October 10, 2024. The survey revealed that the facility was in substantial compliance with 42 CFR Part 494 Conditions for Coverage for End Stage Renal Disease Facilities. However, the following standard level deficiencies were cited which resulted from the facility's noncompliance related to the survey: |