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 012507 (X3) Date Survey Completed 08/15/2025
Name of Provider or Supplier Fresenius Kidney Care Mobile Street Address, City, State 2620 Old Shell Road, Mobile, 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)
V0116 IC-IF TO STATION=DISP/DEDICATE OR DISINFECT
CFR(s): 494.30(a)(1)(i)

Items taken into the dialysis station should either be disposed of, dedicated for use only on a single patient, or cleaned and disinfected before being taken to a common clean area or used on another patient. -- Nondisposable items that cannot be cleaned and disinfected (e.g., adhesive tape, cloth covered blood pressure cuffs) should be dedicated for use only on a single patient. -- Unused medications (including multiple dose vials containing diluents) or supplies (syringes, alcohol swabs, etc.) taken to the patient's station should be used only for that patient and should not be returned to a common clean area or used on other patients.


This STANDARD is not met as evidenced by:
Based on observation, interview, and policy review, the facility failed to ensure the hemostats and clamps used in patient care were disinfected appropriately. This increased the risk of cross contamination for 105 of 105 patients receiving care at the facility. Findings include: During a tour of the treatment floor on 08/13/25 at 8:55 AM, the blue clamps (hemostats) used in patient care were observed to be drained, next to the bleach container. There was one clamp seen on the top of the pile that was observed to be in the closed position versus the open position to ensure adequate disinfection and drainage of the interior surface of the clamp. During an interview on 08/13/25 at 8:55 AM, the Certified Clinical Hemodialysis Technician (CCHT) 17 confirmed the clamp on top was in the closed position and should have been in the open position during draining after disinfection. During an interview on 08/13/25 at 9:30 AM, the Clinic Manager 2 confirmed the clamps were to be in the opened position when draining. He/she confirmed the staff did not follow the policy. Review of the facility's policy titled, "Cleaning and Disinfecting Plastic Hemostat Clamps and Vascular Clamp" dated 07/01/24 revealed, ". . . Air dry in the opened position . . ."