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 852587 (X3) Date Survey Completed 02/07/2025
Name of Provider or Supplier Fresenius Kidney Care Richmond County Street Address, City, State 2556 Tobacco Road Suite A, Hephzibah, 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)
V0402 PE-BUILDING-CONSTRUCT/MAINTAIN FOR SAFETY
CFR(s): 494.60(a)

The building in which dialysis services are furnished must be constructed and maintained to ensure the safety of the patients, the staff and the public.


This STANDARD is not met as evidenced by:
Based on observation and staff interviews, and the recommendations of the Centers for Disease Control and Prevention (CDC), it was determined that the facility failed to maintain the integrity of the building to ensure the safety of the 37 patients who dialyzed at this facility. This failure could hinder effective cleaning and disinfection of the surfaces, thus the potential for microbial growth. This deficient practice was observed in one of one Dialysate Preparation Room and one of one Dialysis Treatment Room. Findings include: During a tour of the facility with the Facility Administrator on 2/5/25 at 10:00 a.m., the following was revealed: In the Dialysis Preparation Room: - There was a large, dead cockroach covered with dust, screws (3 small fasteners), and dirt particles on the floor in the corner next to the drain under the Aqua B Plus ring sample port; the same drain had greenish gold color fuzz substance on top of the drain, and around it. - Behind both carbon tanks, there were old RPC strips (used to test the water for chlorine and chloramine), strewn on the floor, mixed with dust and dirt particles. The drain line (PVC Piping) located behind the carbon tanks had a blackish gold fuzz around the piping where water drained out. In the Patient Treatment Room: - Inside the clean Utility closet, there were two ceiling tiles with rust-colored stains. - Two ceiling tiles over Station (S), (S7) had rust-colored stains. - Two ceiling tiles over clean sink #2 had rust-colored stains. - The wall boxes (frames recessed into the wall at each dialysis station that contain ports for the dialysis machine), at S1, S3, S7, S8, S9, and S10, had thick, white substance that covered each large black hose that was connected to the dialysis machines. The wall behind these stations was splattered with the same thick, white substance. On 2/5/25 at 10:20 a.m., the Facility Administrator acknowledged these findings and stated that the facility's sprinkler system malfunctioned, which got the ceiling tiles wet. - A review of CDC Recommendations stated, that due to the unique infection prevention and control challenges associated with wall boxes, the CDC recommends that staff receive proper education on the essential practices for cleaning, disinfecting, and maintaining these boxes. Cleaning inside and around the wall boxes is crucial to minimizing the risk of infections in patients, especially considering that wall boxes can be prone to contamination by microorganisms, which can then be transmitted to dialysis patients, a population particularly vulnerable to infections.