| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852575 | (X3) Date Survey Completed 08/09/2023 |
| Name of Provider or Supplier Cc&D Services | Street Address, City, State 5040 Snapfinger Woods Dr, Ste 108, Decatur, 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) |
| V0556 | POC-COMPLETED/SIGNED BY IDT & PT CFR(s): 494.90(b)(1) The patient's plan of care must- (i) Be completed by the interdisciplinary team, including the patient if the patient desires; and (ii) Be signed by the team members, including the patient or the patient's designee; or, if the patient chooses not to sign the plan of care, this choice must be documented on the plan of care, along with the reason the signature was not provided. This STANDARD is not met as evidenced by: Based on a review of medical records and staff interview, it was determined that the facility failed to ensure that one of one patient sampled for anemia (P#2) and one of one patient sampled for bone/mineral outcomes (P#3), had an annual patient care plan completed by the Interdisciplinary Team (IDT), signed by the IDT, and by the patient or designee to acknowledge that the information in the plan of care was discussed with the patient or designee, or documentation of the patients' refusal if they chose not to sign. Findings include: During a review of medical records, the following was revealed: - P#2's care plan dated 5/5/23, was incomplete and was not signed by the IDT, nor by P#2 or a designee. - P#3's care plan dated 2/15/23, was incomplete and was not signed by the IDT, nor by P#3 or a designee. During an interview with the Facility Administrator on 8/7/23 at approximately 1:30 p.m.., she stated that the IDT should have completed the care plans with signatures from the patients. |