| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852553 | (X3) Date Survey Completed 10/31/2024 |
| Name of Provider or Supplier Flint River Dialysis | Street Address, City, State 700 Gordon Avenue, Bainbridge, 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) |
| V0403 | PE-EQUIPMENT MAINTENANCE-MANUFACTURER'S DFU CFR(s): 494.60(b) The dialysis facility must implement and maintain a program to ensure that all equipment (including emergency equipment, dialysis machines and equipment, and the water treatment system) are maintained and operated in accordance with the manufacturer's recommendations. This STANDARD is not met as evidenced by: Based on observation and staff interview, it was determined that the facility failed to maintain a safe environment as evidenced by torn leather upholstery in three of 19 patient treatment chairs in Station (S) 4, S6, and S18. This failure could hinder effective cleaning and disinfection of the surfaces and could negatively affect the health and safety of all patients who used these hemodialysis chairs. Findings include: During observation in the Patient Treatment Room on 10/30/24 between 8:57 a.m. and 10:59 a.m., the following was observed: The hemodialysis chairs at S4, S6, and S18 had torn upholstery ranging from approximately 2 inches to 8 inches in length and diameter, along the sides and top of the armrests, on the seats, and/or on the back rests. During an interview with the Facility Administrator on 10/30/24 at 3:47 p.m., the Facility Administrator stated that chairs have been on back order since August 2023. |