| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852551 | (X3) Date Survey Completed 01/15/2025 |
| Name of Provider or Supplier Duluth Dialysis | Street Address, City, State 3170 Peachtree Ind Blvd, Ste 100, Duluth, 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) |
| V0750 | CFC-GOVERNANCE CFR(s): 494.180 This CONDITION is not met as evidenced by: Based on observations, a review of records, staff interviews, review of the manufacturer's Directions for Use (DFU) and a review of facility Policy and Procedures (P & P), it was determined that the Governing Body failed to demonstrate responsibility and accountability for the operations of the facility. This failure had the potential to negatively affect the health and safety of 32 in-center hemodialysis patients who dialyzed at this facility. Findings were: Cross Reference: V 250 - Failure of the facility to ensure that three of three Patient Care Technicians (PCT AA, PCT BB and PCT CC) observed, verified the machine's dialysate pH, according to the manufacturer's Directions For Use (DFU) and facility P&P. |