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)
V0557 POC-INITIAL IMPLEMENTED-30 DAYS/13 TX
CFR(s): 494.90(b)(2)

Implementation of the initial plan of care must begin within the latter of 30 calendar days after admission to the dialysis facility or 13 outpatient hemodialysis sessions beginning with the first outpatient dialysis session.


This STANDARD is not met as evidenced by:
Based on a review of medical records and staff interviews it was determined that the facility failed to ensure the interdisciplinary team (IDT) developed and implemented an initial plan of care for one of one patient (P) (P#1) sampled for new admission, within the latter of 30 calendar days after admission to the dialysis facility or 13 outpatient hemodialysis sessions beginning with the first outpatient dialysis session. Findings include: P#1 was admitted to the facility on 5/13/24. During an interview on 8/14/24 at 3:30 p.m., the Facility Administrator revealed that the CIPA/POC (Comprehensive Interdisciplinart Patient Assessment/Plan of Care) has not been completed by the physician, social worker, and the dietitian; the RN was the only member of the IDT who has completed the CIPA/POC.