| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852552 | (X3) Date Survey Completed 09/14/2023 |
| Name of Provider or Supplier Fresenius Kidney Care Mcdonough | Street Address, City, State 50 Kelly Road, Ste 100, Mcdonough, 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 | An unannounced onsite survey was conducted on September 14, 2023 to investigate complaint #GA00238561. One of four allegations was substantiated. The investigation revealed that the facility was not in compliance with 42 CFR 494.40 - Water and Dialysate Quality and 42 CFR Part 494.180 - Governance, for End Stage Renal Disease Facilities. The following standard level deficiency was also cited which resulted from the facility's noncompliance related to the survey: |