| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852567 | (X3) Date Survey Completed 05/17/2023 |
| Name of Provider or Supplier Fairburn Palmetto Dialysis | Street Address, City, State 501 Walnut Way, Palmetto, 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 GA00234285 was initiated at Fairburn Palmetto Dialysis on May 17, 2023 and concluded on May 17, 2023. The allegation was substantiated and the following standard level deficiency was cited: |
| V0456 | PR-PARTICIPATE IN CARE;DISC/REFUSE TX CFR(s): 494.70(a)(5) The patient has the right to- (5) Be informed about and participate, if desired, in all aspects of his or her care, and be informed of the right to refuse treatment, to discontinue treatment, and to refuse to participate in experimental research; This STANDARD is not met as evidenced by: Based on a review records and staff and patient interviews, it was determined that the facility failed to inform 11 of 11 patients (P)sampled (P#1, P#2, P#3, P#4, P#5, P#7, P#8, P#9, P#10, P#11 and P#12) of the change in their medication used for anemia (a condition in which the body does not have enough healthy red blood cells) management. This failure violated the right of the 11 sampled patients, to know about and participate in their care and treatment to the extent they desire. A review of the Governing Body minutes revealed that on 2/27/23, the facility adopted to change the formulary erythropoiesis-stimulating agent (ESA) to Mircera from Epogen (both medications used to treat anemia caused by chronic renal failure). A review of the facility's complaints and grievances from November 2022 - April 2023 revealed one complaint dated 4/14/23 from Patient (P) #7 in reference to not receiving information on a new medication being given in the facility for anemia. An interview with the Social Worker on 5/17/23 at approximately 10:00 a.m. revealed that she did receive the complaint about P#7 not receiving any education on the new medication given for anemia. She also stated that she gave the complaint to the Facility Administrator (FA) to investigate and finalize with the patient. During an interview with the FA on 5/17/23 at approximately 11:30 a.m., it was revealed that all patients were supposed to receive an information sheet about their new anemia medication that started on 3/1/23. She stated that the nurses were supposed to discuss the information with the patients when they administered the new medication. She also stated that she talked to P#7 however, did not document findings and resolution of the complaint. An interview with P#1, P#2, P#3, P#4, and P#5 on 5/17/23 between 9:00 a.m. and 12:00 p.m. revealed they did not recognize the new anemia medication sheet. They stated they knew they took a medication for their anemia. P#7 stated she was never informed of the new medication and found out after it was given and was trying to figure out why she was feeling bad. A review of medical records of P#8, P#9, P#10, P#11 and P#12 revealed no documented evidence that the patients received information or education on the new medication for anemia. An interview with the Charge Nurse on 5/17/22 at approximately 11:00 a.m. revealed she came to this facility after the implementation of Mircera. She stated she does let patients know what they are receiving when giving medications. She also stated that two of the patients were unable to stay on Mircera and went back to Epogen due to side effects and the patients only received two doses since Mircera is only given every two weeks. She also stated that the nurses that were at the facility when the Mircera was adopted were no longer employed at this facility. |