| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852541 | (X3) Date Survey Completed 02/06/2020 |
| Name of Provider or Supplier Cairo Dialysis | Street Address, City, State 1182 5th St., S.E., Cairo, 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) |
| V0557 | POC-INITIAL IMPLEMENTED-30 DAYS/13 TX CFR(s): 494.90(b)(2) Implementation of the initial plan of care must begin within the latter of 30 calendar days after admission to the dialysis facility or 13 outpatient hemodialysis sessions beginning with the first outpatient dialysis session. This STANDARD is not met as evidenced by: Based on a review of medical records and staff interviews, it was determined that the facility failed to ensure that a plan of care was developed and implemented within 30 days of admission for two of three patients (P) (#2 and #3) sampled, who were admitted to this facility in 2019. Findings were: A review of medical records revealed the following: - P#2 was admitted on 12/12/19. The plan of care was not developed and implemented until 1/30/20. - P#3 was admitted on 2/19/19. The plan of care was not developed and implemented until 3/27/19 During an interview with the Facility Administrator (FA) and Clinical Services Specialist on 2/6/20 at 2:45 p.m., the FA stated that the plans should have been completed within the 30 day period as required. |