| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852569 | (X3) Date Survey Completed 06/23/2023 |
| Name of Provider or Supplier Dialysis Center Of Athens | Street Address, City, State 210 Hawthorne Park, Athens, 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) |
| V0175 | CFC-WATER & DIALYSATE QUALITY CFR(s): 494.40 This CONDITION is not met as evidenced by: Based on observation, staff interviews, a review of the manufacturer's directions for use (DFU), and a review of the facility's Policy and Procedures (P&P), it was determined the facility failed to ensure the water used for dialysis was accurately monitored to provide safe treatment for all patients. This failure had the potential to cause harm to the health and safety of four of four patients (P) (P#2, P#3, P#4, and P#5), who were receiving Hemodialysis treatment at the time of this observation. Findings include: Cross Reference: V196 - Failure of the facility to ensure that staff accurately performed the Total Chlorine Test of water used for dialysis to ensure the water was safe for dialysis. |