| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 01G011 | (X3) Date Survey Completed 07/13/2023 |
| Name of Provider or Supplier Rainbow Omega, Inc, | Street Address, City, State 202 Hope Drive, Eastaboga, AL | |
| 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) |
| W0000 | A Recertification Survey was conducted at Davis / Orman Intermediate Care Facility from 07/12/2023 - 07/13/2023. The facility is in substantial compliance respective to applicable Condition of Participation (CoP) under 42 CFR 483, Subpart I with the following standard-level deficiencies cited. |