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 852539 (X3) Date Survey Completed 08/02/2024
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)
V0113 IC-WEAR GLOVES/HAND HYGIENE
CFR(s): 494.30(a)(1)

Wear disposable gloves when caring for the patient or touching the patient's equipment at the dialysis station. Staff must remove gloves and wash hands between each patient or station.


This STANDARD is not met as evidenced by:
Based on observation, a review of Centers for Disease Control and Prevention (CDC) Recommendations, and staff interview, it was determined that the Infection Control Committee failed to ensure that three of three patients (at Station (S) #3, S4, and S7) observed, who held pressure to their access sites for hemostasis (stopping of the flow of blood) after dialysis, performed hand hygiene (wash hands with soap and water or use an alcohol based hand sanitizer) after glove removal and prior to leaving the facility. This deficient practice had the potential for cross contamination and increased risk of infection. The facility census was 10. Findings were: During observation in the patient treatment area on 7/31/24 between 10:41 a.m. and 11:58 a.m., the following was observed: - Patients who were seated at S3, S4, and S7 held pressure to their dialysis access sites and left the facility without performing hand hygiene. The patients were not reminded by staff to wash their hands nor were offered to use hand sanitizer after glove removal. According to the CDC, even with glove use, hand hygiene is necessary after glove removal because hands can become contaminated through small defects in gloves and from the outer surface of gloves during glove removal. A review of undated facility policy titled, "Handwashing Technique" under Handwashing Procedure showed the following: Indications for handwashing and hand antisepsis: " ...Decontaminate hands after removing gloves". The above findings were discussed with the Facility Administrator on 7/31/24 at 1:00 p.m. and did not offer any comments.