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 852552 (X3) Date Survey Completed 08/16/2024
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 {CORE} An unannounced Recertification survey was conducted at Fresenius Kidney Care McDonough from August 14, 2024 through August 16, 2024. The survey revealed that the facility was in substantial compliance with 42 CFR Part 494 Conditions for End Stage Renal Disease Facilities. The following standard level deficiencies were cited: