| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852540 | (X3) Date Survey Completed 04/20/2018 |
| Name of Provider or Supplier Camilla Dialysis | Street Address, City, State 251 Us 19 N, Camilla, 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) |
| V0401 | PE-SAFE/FUNCTIONAL/COMFORTABLE ENVIRONMENT CFR(s): 494.60 The dialysis facility must be designed, constructed, equipped, and maintained to provide dialysis patients, staff, and the public a safe, functional, and comfortable treatment environment. This STANDARD is not met as evidenced by: Based on record reviews, observations and staff interviews, it was determined that the facility failed to provide a safe environment, free of hazards for staff and all 64 patients that dialyze at the facility. Findings were: During a tour of the facility on 4/18/18 between 3:00 p.m. and 4:00 p.m., accompanied by the facility administrator, the following was observed: - The door frames at the entry to the offices, the treatment area and the waiting room were damaged and discolored with black marks and, some of the paint was missing, exposing the metal underneath. - The walls in the treatment area next to station #1 and #7 had peeling paint and damaged areas measuring approximately 3-4 inches wide exposing white colored sheetrock. During a discussion with the facility administrator on 4/18/18 at approximately 4:30 p.m., he/she stated that management was aware that the walls in the treatment room between stations #1-#7 needed to be repaired. |