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 013424 (X3) Date Survey Completed 09/11/2025
Name of Provider or Supplier Regional Medical Center Clinics Street Address, City, State 125 Church Street, Georgiana, 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)
J0000 A recertification survey was conducted at Regional Medical Center Clinics from 9/10/25 to 9/11/25. Standard level deficiences were cited and will require a plan of correction.