Davita Interamerican Dialysis Center

“IC-WEAR GLOVES/HAND HYGIENE CFR(s): 494.30(a)(1) Wear disposable gloves when caring for the patient or touching the patient’s equipment at the dialysis station. Staff must remove gloves and wash hands between each patient or station. This Standard is not met as evidenced by: 47207 Based on policy and procedures review, observations and interviews, the facility failed to ensure that 1 out of 7 Staff (Staff 7/ Patient Care Technician) followed standard infection control during the initiation of dialysis treatment via an Arteriovenous Fistula (AVF). This affected 1 out of 14 sampled patients. Patient #4 Findings include: A review of the facility’s Policy 1-05-01 Infection Control for Dialysis Facilities, Origination Date: September 2007, Revision Date: April 2023, revealed it included but was not limited to: Hand hygiene: 1. All teammates, Physicians and Non-Physicians (NP) will perform hand hygiene ... d. after patient and dialysis delivery system contact.” During the In Center Dialysis Observation completed on 12/01/2025 at 11:38 a.m. along with Staff 3 (Charge Nurse), Staff 7 (Patient Care Technician) was observed connecting Patient #4’s AVF for dialysis treatment. While in the the process of connecting Patient #4 to the dialysis delivery system, Staff 7 (Patient Care Technician) stopped, and then proceeded to touch the hemodialysis machine screen to stop an alarm. Staff 7 (Patient Care Technician) then returned to attaching Patient #4’s dialysis lines without performing hand hygiene. During an interview conducted on 12/01/2025 at 11:45 a.m., Staff 7 (Patient Care Technician) stated “Did I? I don’t remember doing that.” During an interview conducted on 12/01/2025 at 2:35 p.m., Staff 2 (Facility Administrator) was informed of the findings, she stated “We will have an in-service done for staff.””

“IC-DISINFECT SURFACES/EQUIP/WRITTEN PROTOCOL CFR(s): 494.30(a)(4)(ii) [The facility must demonstrate that it follows standard infection control precautions by implementing- (4) And maintaining procedures, in accordance with applicable State and local laws and accepted public health procedures, for the-] (ii) Cleaning and disinfection of contaminated surfaces, medical devices, and equipment. This Standard is not met as evidenced by: 47207 Based on policy and procedures review, observations and interviews, the facility failed to ensure that 1 out of 12 sampled staff (Staff 3/ Charge Nurse) followed standard infection control while cleaning the dialysis station chair after a patient had left the facility. Findings include: A review of the facility’s Policy 1-05-01 Infection Control for Dialysis Facilities, Origination Date: September 2007, Revision Date: April 2023, revealed it included but was not limited: Section: Disinfection 12. b. iii. Surfaces should be allowed to air dry in order to provide sufficient disinfectant contact time. During the In Center Dialysis observations completed on 12/01/2025 at 1:40 p.m., Staff 3 (Charge Nurse) stated “I am going to help the staff out by cleaning this station (15).” Staff 3 (Charge Nurse) then started to clean the dialysis chair. He opened the side wings of the chair, cleaned the inside and closed them immediately. In an interview on 12/01/2025 at 1:45 p.m., Staff 3 (Charge Nurse) was asked how long should the wings of the chair be left open to dry? He stated “5 minutes”. During an interview conducted on 12/01/2025 at 2:30 p.m., Staff 2 (Facility Administrator) was informed of the above findings, she stated “We will go over that.””

“PE-EQUIPMENT MAINTENANCE-MANUFACTURER’S DFU CFR(s): 494.60(b) The dialysis facility must implement and maintain a program to ensure that all equipment (including emergency equipment, dialysis machines and equipment, and the water treatment system) are maintained and operated in accordance with the manufacturer’s recommendations. This Standard is not met as evidenced by: 47207 Based on observations and interviews, the facility failed to ensure that expired Green Top Vacutainer tubes were discarded. Findings include: During the In Center Dialysis observations in the laboratory area of the facility on 12/01/2025 at 11:30 a.m., the surveyor found a tray of Green Top Vacutainers tubes with only 4 tubes remaining in the tray. Further observation revealed the expiration date for all 4 tubes was 9/30/2025. Additionally, there was an unopened tray of Green Top Vacutainer tubes with an expiration date of 11/30/2025. In an interview conducted on 12/01/2025 at 11:35 a.m., Staff 3 (Charge Nurse) was asked about the expired tubes. Staff 3 reviewed and confirmed that the Green Top Vacutainer tubes had expired on 9/30/2025 and 11/30/2025 respectively and stated, “We have been running low on these.” The surveyor stated, “You have several trays that are not expired; why are you using these?” Staff 3 responded, “I will get rid of these now.” During an interview conducted on 12/01/2025 at 2:30 p.m., Staff 2 (Facility Administrator) was informed of the above findings and stated, “Did Staff 3 throw them out?””