Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391

Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number 852542 (X3) Date Survey Completed 05/18/2021
Name of Provider or Supplier Red Hills Dialysis Street Address, City, State 201 Old Albany Road, Thomasville, 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 by Healthcare Management Solutions, LLC on behalf of Centers for Medicare and Medicaid Services (CMS). An unannounced on-site recertification survey (ASPEN ID #EHU611) conducted at the above-named End Stage Renal Disease (ESRD) facility from 05/17/21-05/18/21 resulted in a finding of substantial compliance respective to applicable Conditions for Coverage (CfC) under 42 CFR 494, Subpart A through D with the following standard-level deficiencies listed below. Total Facility Census: 85 In-Center Hemodialysis: 85 Home Hemodialysis (HHD): 0 Peritoneal Dialysis (PD): 0 Nocturnal: 0 Pediatrics: 0 Sample Size: 8 Network 6 was contacted after entrance.