| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852539 | (X3) Date Survey Completed 06/10/2021 |
| Name of Provider or Supplier Eatonton Kidney Center | Street Address, City, State 103 N Washington Avenue, Eatonton, 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 | A Recertification (CORE) and COVID-19 Focused Infection Control Survey was conducted at Eatonton Kidney Center from June 8, 2021 through June 10, 2021. The survey revealed that the facility was not in compliance with 42 CFR Part 494. 90 - Patient Plan of Care, 42 CFR Part 494.110 - Quality Assessment and Performance Improvement (QAPI), and 42 CFR Part 494.180 - Governance for End Stage Renal Disease Facilities. The following standard level deficiencies were also cited which resulted from the facility's noncompliance related to the survey: |