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 852569 (X3) Date Survey Completed 07/23/2025
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)
E0028 Dialysis Emergency Equipment

ยง494.62(b)(9) Condition for Coverage: [(b) Policies and procedures. The dialysis facility must develop and implement emergency preparedness policies and procedures, based on the emergency plan set forth in paragraph (a) of this section, risk assessment at paragraph (a)(1) of this section, and the communication plan at paragraph (c) of this section. The policies and procedures must be reviewed and updated at least every 2 years. At a minimum, the policies and procedures must address the following:] (9) A process by which the staff can confirm that emergency equipment, including, but not limited to, oxygen, airways, suction, defibrillator or automated external defibrillator, artificial resuscitator, and emergency drugs, are on the premises at all times and immediately available.


This STANDARD is not met as evidenced by:
Based on observation, staff interviews, and a review of the American Heart Association (AHA) recommendations, it was determined that the facility failed to ensure that expired supplies in one of one Emergency Crash Cart, were removed and not made available for use, and re-supplied in order to be in a ready-to-operate condition. This deficient practice had the potential to negatively affect the health and safety of 10 in-center hemodialysis patients who were under the care of this facility. Findings include: During a tour in the Patient Treatment Room on 7/21/25 from 9:56 a.m. through 10:32 a.m., the following supplies had expired, thus these were not suitable for use. In the Emergency Crash Cart: - Two of two pads used for an Automatic External Defibrillator (a portable device that analyzes heart rhythm and delivers an electric shock to restore a normal rhythm during cardiac arrest), expired 3/20/24 and 4/5/25 respectively, therefore it was not in a ready-to-operate condition. - On 7/21/25, Registered Nurse (RN AA) , who was also the Charge Nurse, acknowledged these findings at 10:15 a.m. -According to AHA recommendation, AED pads should be replaced before their expiration date. Expired pads may not adhere properly to the skin, and their adhesive gel can dry out, making them ineffective in delivering a life-saving shock.