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 012515 (X3) Date Survey Completed 04/20/2023
Name of Provider or Supplier Fresenius Medical Care Opelika Street Address, City, State 2609 Village Professional Drive, Suite 2, Opelika, 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)
V0117 IC-CLEAN/DIRTY;MED PREP AREA;NO COMMON CARTS
CFR(s): 494.30(a)(1)(i)

Clean areas should be clearly designated for the preparation, handling and storage of medications and unused supplies and equipment. Clean areas should be clearly separated from contaminated areas where used supplies and equipment are handled. Do not handle and store medications or clean supplies in the same or an adjacent area to that where used equipment or blood samples are handled. When multiple dose medication vials are used (including vials containing diluents), prepare individual patient doses in a clean (centralized) area away from dialysis stations and deliver separately to each patient. Do not carry multiple dose medication vials from station to station. Do not use common medication carts to deliver medications to patients. If trays are used to deliver medications to individual patients, they must be cleaned between patients.


This STANDARD is not met as evidenced by:
Based on observation, facility policy, and interview, it was determined the staff failed to ensure only individual patient's medications were taken to their dialysis station. This did affect one of one random observation on the treatment floor and had the potential to negatively affect all patients who dialyze at the facility. Findings include: Facility Policy: Medication Preparation and Administration Published: 4/5/21 Version: 6 Purpose: To administer medications with the goals of staff and patient safety, optimal therapeutic response, and infection control. ...Infection Control Medications shall be prepared...away from dialysis patient stations and delivered separately to each patient. 1. During an observation on the treatment floor on 4/18/23 at 10:29 AM, Employee Identifier (EI) # 4, Registered Nurse (RN) entered the patient treatment floor around the area of stations 5 and 10 with two prefilled/prepared IV (Intravenous) medications in hand. EI # 4 placed one of the IV prefilled/prepared syringes on the chairside table of station 10, then exited the station. EI # 4 then proceeded to station 5 and placed the remaining IV prefilled/prepared syringe on the chairside table of station 5. EI # 4 failed to ensure only individual patient's medications were taken to their dialysis station. An interview was conducted on 4/20/23 at 10:50 AM with EI # 1, Director of Operations, who confirmed staff failed to follow the facility policy and deliver medications separately to each patient.