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 852575 (X3) Date Survey Completed 08/14/2024
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)
V0407 PE-HD PTS IN VIEW DURING TREATMENTS
CFR(s): 494.60(c)(4)

Patients must be in view of staff during hemodialysis treatment to ensure patient safety, (video surveillance will not meet this requirement).


This STANDARD is not met as evidenced by:
Based on observation and staff interviews, it was determined that the facility failed to ensure that two of nine patients, (P), (P#9 and P#10) observed, had their vascular access sites uncovered/visible to the staff throughout their hemodialysis treatment, to ensure patient safety. This deficient practice could provide an opportunity for accidental needle dislodgement or a line disconnection to go undetected and could result in exsanguination (severe loss of blood), to P#9 and P#10. The facility census was 19. Findings include: During observation in the Patient Treatment Room on 8/14/24 between 8:30 a.m. and 9:00 a.m., the following was revealed: - P#9 and P#10 who were seated in Station (S) 5 and S6 respectively, had their access sites completely covered with a blanket. This surveyor immediately notified RN AA on 8/14/24 at 8:35 a.m. RN AA stated patients will not comply with keeping access uncovered but was unable to find documented evidence. RN AA uncovered access site of both patients. P#9 kept access uncovered afterward; P#10 did not.