| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852554 | (X3) Date Survey Completed 11/22/2022 |
| Name of Provider or Supplier Panola Dialysis | Street Address, City, State 5360 Snapfinger Woods Dr, Ste 102, Stonecrest, 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 onsite investigation of complaint #GA00229006 was conducted at Panola Dialysis on November 22, 2022. The survey revealed that the facility was in substantial compliance with 42 CFR Part 494 Condition for Coverage for End Stage Renal Disease Facilities. The allegation was substantiated. The following standard level deficiency resulted from the facility's noncompliance related to the survey: |