| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852561 | (X3) Date Survey Completed 03/05/2025 |
| Name of Provider or Supplier Fresenius Kidney Care Dallas | Street Address, City, State 112 Village Walk, Dallas, 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 survey to investigate complaint GA00254065 was conducted at Fresenius Medical Care Dallas on March 5, 2025. The survey revealed that the facility was not in compliance with 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: |