| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 012506 | (X3) Date Survey Completed 04/13/2023 |
| Name of Provider or Supplier Dothan Dialysis | Street Address, City, State 216 Graceland Drive, Dothan, 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) |
| V0250 | DIALYS PROPORT-MONITOR PH/CONDUCTIVITY CFR(s): 494.40(a) 5.6 Dialysate proportioning: monitor pH/conductivity It is necessary for the operator to follow the manufacturer's instructions regarding dialysate conductivity and to measure approximate pH with an independent method before starting the treatment of the next patient. This STANDARD is not met as evidenced by: Based on observations, facility procedure, and interviews, it was determined the facility failed to ensure staff followed the facility procedure for pH (potential of hydrogen) testing of the dialysate. This did affect PI (Patient Identifier) # 14 and PI # 1, two of four observations for testing of the pH for dialysis machine preparation and had the potential to negatively affect all patients who dialyzed at this facility. Findings include: Facility Procedure: Testing pH For Dialysate using RPC E-Z CHEK K100-0117 6.8-8.5 Test Strips Procedure Number: 2-08-01K Revision Date: October 2020 ...2. Obtain dialysate sample...then allow fluid to flow over the pad for one (1) second 3. Remove the strip from the fluid...shake off excess dialysate. After 10 (ten) seconds, compare the strip to the color chart on the bottle. 4. Match the strip as closely... 6. If results are outside the limit of 6.9-7.6, repeat test on another dialysate sample... 1. An observation was conducted on 4/12/23 at 10:10 AM with Employee Identifier (EI) # 8, CCHT (Certified Clinical Hemodialysis Technician), to observe pH testing at station 5 prior to treatment initiation for PI # 14. EI # 8 obtained the dialysate sample, allowed fluid to flow over the test pad, shook excess fluid off the strip, compared the test strip to the test strip color chart, then immediately read pH results as 7.0. EI # 8 failed to allow 10 seconds to pass before comparing the test strip to the color chart. An interview was conducted on 4/13/23 at 11:05 AM with EI # 1, Facility Administrator, who confirmed staff failed to follow the procedure for pH testing. 2. An observation was conducted on 4/12/23 at 11:05 AM with EI # 4, CCHT, to observe pH testing at station 15 prior to treatment initiation for PI # 1. EI # 4 obtained the dialysate sample, allowed fluid to flow over the test pad, shook excess fluid off the strip, compared the test strip to the test strip color chart, then immediately read pH results 7.6. EI # 4 failed to allow 10 seconds to pass then compare the test strip to the color chart. An interview was conducted on 4/13/23 at 11:05 AM with EI # 1 who confirmed staff failed to follow the procedure for pH testing. 41624 |