| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852579 | (X3) Date Survey Completed 06/07/2023 |
| Name of Provider or Supplier Home Dialysis Services Norcross, Llc | Street Address, City, State 3780 Holcomb Bridge Road, Suite E, Norcross, 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) |
| V0587 | H-FAC RECEIVE/REVIEW PT RECORDS Q 2 MONTHS CFR(s): 494.100(b)(2),(3) The dialysis facility must - (2) Retrieve and review complete self-monitoring data and other information from self-care patients or their designated caregiver(s) at least every 2 months; and (3) Maintain this information in the patient ' s medical record. This STANDARD is not met as evidenced by: Based on a review of records and staff interview, it was determined that the facility failed to ensure that two of two sampled peritoneal dialysis (PD) patients (P#2 and P#3) treatment flowsheets were reviewed at least every two months, to determine if the patients were following their prescribed treatment plan and/or having problems with dialysis at home. Failure to monitor home patient's status by reviewing dialysis treatment records, could negatively affect the health and safety of the 27 PD patients who were receiving PD services at this facility. Findings include: A review of P#2 and P#3's treatment records dated 2/1/23 through 5/30/23 , revealed the following: There was no documentation to confirm that the patient's home treatment flowsheets were reviewed by a nurse, to determine if P#2 and P#3 were following the prescribed treatment plan or having any documented problems with home dialysis. During an interview with the HomeTraining Nurse on 6/6/23 at approximately 3:00 p.m., she stated that the treatment flowsheets were reviewed however should have been signed. |