| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852550 | (X3) Date Survey Completed 03/25/2021 |
| Name of Provider or Supplier Dublin Kidney Institute | Street Address, City, State 207 Industrial Blvd Ste 2, Dublin, 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) |
| V0402 | PE-BUILDING-CONSTRUCT/MAINTAIN FOR SAFETY CFR(s): 494.60(a) The building in which dialysis services are furnished must be constructed and maintained to ensure the safety of the patients, the staff and the public. This STANDARD is not met as evidenced by: Based on observation and staff interview, it was determined that the facility failed to provide a method for patients and staff to summon immediate/emergency assistance, from the Examination (Exam) Room to ensure safety for all patients. This deficient practice was observed in one of one Patient Exam Room. Findings include: During a tour of the facility with the Home Program Therapy Nurse (RN AA), who was also the Facility Administrator, on 3/22/21 at 3:30 p.m., the following was observed: The Patient Exam Room did not have an emergency call system, nor a telephone in place for the patients, and staff to summon emergency assistance if needed. RN AA stated on 3/22/21 at 3:35 p.m., that an emergency call system was needed in the Patient's Exam Room. |