| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852539 | (X3) Date Survey Completed 06/10/2021 |
| Name of Provider or Supplier Eatonton Kidney Center | Street Address, City, State 103 N Washington Avenue, Eatonton, 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) |
| V0750 | CFC-GOVERNANCE CFR(s): 494.180 This CONDITION is not met as evidenced by: Based on facility record review and staff interviews, it was determined that the Governing Body (GB) failed to demonstrate responsibility and accountability for the operations of the facility. This failure had the potential to cause harm to all 10 patients who were receiving dialysis treatments at this facility. Findings include: Cross references: V 180 - Failure of the facility to promptly take actions for dialysate microbial (bacterial) levels that exceeded the AAMI standards, to ensure that the water used to prepare dialysate was safe. V 402 - Failure of the facility to ensure that there was a safe environment for all 10 in-center hemodialysis patients. V 403 - Failure of the facility to follow the manufacturer's guidelines for the maintenance of the Neo2 Meter. V 519 - Failure of the interdisciplinary team (IDT) to ensure that four of five sampled patients (P#1, P#3, P#4, and P#5) received an annual comprehensive reassessment from each member of the interdisciplinary team (IDT), and the development of the patients' plan of care. V 632 - Failure of the facility to effectively manage anemia (low red blood cell counts) outcomes. |