Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391

Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number 852557 (X3) Date Survey Completed 03/22/2023
Name of Provider or Supplier Fresenius Kidney Care Glynn County Street Address, City, State 3150 Glynn Avenue, Brunswick, 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)
V0506 PA-IMMUNIZATION/MEDICATION HISTORY
CFR(s): 494.80(a)(3)

The patient's comprehensive assessment must include, but is not limited to, the following: Immunization history, and medication history.


This STANDARD is not met as evidenced by:
Based on a review of the Centers for Disease Control and Prevention (CDC) recommendations, medical records review, and staff interview, it was determined that the Infection Control Committee failed to ensure that two of two patients sampled for anemia (P#1 and P#2) received a tuberculin (TB) skin test (an injection under the skin to determine if the patient is positive for tuberculosis). This deficient practice had the potential to negatively affect the health and safety of the 55 patients who dialyzed at this facility. Findings include: A review of the CDC recommendations stated that all dialysis patients, be tested at least once for baseline tuberculin skin test results (TST) and re-screened if TB exposure is detected. Chest x-rays may be used for individuals for whom the TST is not an option. A review of P#1 and P#2's medical records revealed that P#1 and P#2 did not receive an annual TB skin test or TB questionnaire for 2022 - 2023. During an interview with the facility Clinic Manager on 2/21/23 at approximately 2:30 p.m. she stated that the TB testing should have been completed for P's#1 and P#2.