Davita Colton Ranch Dialysis

“PR-PARTICIPATE IN CARE;DISC/REFUSE TX CFR(s): 494.70(a)(5) The patient has the right to- (5) Be informed about and participate, if desired, in all aspects of his or her care, and be informed of the right to refuse treatment, to discontinue treatment, and to refuse to participate in experimental research; This Standard is not met as evidenced by: 44505 Based on interview and record review, the facility failed to ensure patient’s rights were maintained for one of three sampled dialysis patients (Patient 1) when Patient 1 was not informed and educated of the possible symptoms and expectations for not completing his prescribed dialysis treatment (a process of removal waste products and excess fluid from blood when kidneys stop working) before he was sent home, on September 2, 2023. This failure had the potential to compromise Patient 1’s health and could cause shortness of breath, fatigue, nauseous, high blood pressure. Findings: During a review for Patient 1’s “Summary Information Sheet”, the “Summary Information Sheet” indicated, Patient 1 was admitted to the facility on April 13, 2021, with diagnoses which included, End Stage Renal Disease (ESRD - a terminal illness in which a person’s kidneys no longer work properly) and Type 2 Diabetes Mellitus (high blood sugar). A review of “Patient summary Report,” dated February 23, 2024, it indicated Patient 1 has a Central Venous Catheter (CVC- a tube placed into a large vein used for hemodialysis) on his right chest as his dialysis access site, and was scheduled to be dialyze (to undergo dialysis) every Tuesday, Thursday, and Saturday. During a concurrent interview and record review on February 23, 2024, at 2:20 PM, with the Administrator, Patient 1’s “Treatment Details Report,” dated September 2, 2023, was reviewed. The “Treatment Details Report,” stated, “ ... Treatment time: 3h [hours] 15 min [minutes] ... Comment... Pre ... had difficult withdrawing fluids from the arterial cvc port ... Post ... Treatment wasn’t completed due to clotted CVC with inability to draw fluids from the arterial port but able to do flushing. Noted resistance on the venous port and air was drawn instead of fluids. Notified Nephrologist and ordered angiogram (an x-ray of the blood vessels) and possible replacement of access. Pt [patient] left facility with stable condition.” The Administrator was not able to provide documented evidence that Patient 1 was educated regarding what to do if he becomes symptomatic (showing symptoms from not getting dialysis like shortness of breath, fatigue, nauseous, high blood pressure) at home. During an interview with the Dialysis Registered Nurse 1, (RN 1) on March 5, 2024, at 10:15 AM, RN 1 stated Patient 1’s CVC was not functioning on September 2, 2023, and was sent home, not getting his full dialysis treatment on that day. RN 1 further stated, she got busy and failed to remind Patient 1 to go to the Emergency Room (ER) if he was having shortness of breath and not feeling well at home. During a concurrent interview and record review on February 23, 2024, at 2:30 PM with the Administrator, the facility’s Policy, and Procedure (P&P), titled “Patient’s Rights,” dated October 2021, was reviewed. The P&P indicated, “ Your right as a patient: ...1. To be fully informed of my rights, responsibilities and all rules governing conduct related to patient care, services, and financial policies/ responsibilities ...3. To be treated with (i) respect, dignity, and recognition of my individuality, choices, strengths, abilities, cultural values, religious beliefs, and personal needs, to the extent possible during treatment, and (ii) sensitivity to my psychological needs and ability to cope with ESRD ...6. To receive adequate, safe, sanitary, and efficient dialysis treatment and respectful care by competent personnel in a comfortable environment ...7. To receive all information in a way that I can understand ...16. To receive a full explanation by my physician/ allied health professional of the nature of my medical status and the necessity for recommended treatment/ appointments, including the risks, side effects, expected outcomes and other treatment/ appointment options before giving consent to or refusing treatment/ appointment...” The Administrator stated the expectation is for the staff to educate patients regarding their dialysis treatment and what to expect if their CVCs are not working properly.”