| 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) |
| V0713 | MD RESP-STAFF ED, TRAINING & PERFORM CFR(s): 494.150(b) Medical director responsibilities include, but are not limited to, the following: (b) Staff education, training, and performance. This STANDARD is not met as evidenced by: Based on a review of facility records, and staff interviews, it was determined that the Medical Director (MD) failed to ensure that one of one Home Therapy Registered Nurse (RN AA), was trained to perform his/her job responsibilities, and performance evaluations were conducted to ensure comprehension of training. This failure had the potential to negatively affect the health and safety of 16 of 16 peritoneal dialysis (PD) patients, and one of one home hemodialysis (HHD) patient. Findings include: Cross Reference: V 681 - Failure of the Medical Director to ensure that one of one Home Hemodialysis (HHD) Registered Nurse (RN AA), had completed training in Home Hemodialysis, with current skills checks to evaluate her ability to perform the duties that was assigned to her. |