Homestead Artificial Kidney 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: 40153 Based on observations and interviews, the facility failed to practice hand hygiene during initiation of the Central Venous Catheter (CVC) for 1 of 1 observations (Patient #14). The findings included: A chart review revealed that Patient #14 was admitted to the facility on 01/18/2021 for in-house hemodialysis. In an observation conducted on 08/18/25 at 12:02 PM, Staff P, Patient Care Technician, was observed at station #4 initiating a Central Venous Catheter for Hemodialysis on Patient #14. Staff P used hand sanitizer and donned clean gloves. She lifted the leg rest of the dialysis chair and touched Patient #14’s sweater. She then proceeded to touch the access site without changing her gloves and cleaning her hands in between. In an interview conducted on 08/20/2025 at 12:00 PM, with the facility’s Clinical Manager, she was told of the findings.”

“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: 40153 Based on observations and interviews, the facility failed to ensure that the equipment was in proper working order and the biohazard containers were sealed during 1 of 1 tour in the main dialysis treatment room. The findings included: In an observation conducted on 08/18/25 at 10:49 AM, the Biohazard refrigerator was noted with an internal temperature of 59 degrees Fahrenheit, and not the necessary 40 degrees Fahrenheit or below. In an observation conducted on 08/18/25 at 10:51 AM in the main dialysis treatment room, 2 out of 4 Biohazard red bins were noted to have no lids and were not sealed. In an interview conducted on 08/18/25 at 11:00 AM with Staff C, Registered Nurse, he said that he checked the Biohazard refrigerator earlier, and it showed 40 degrees Fahrenheit or below. In an observation conducted on 08/18/25 at 11:58 AM, the Biohazard refrigerator was noted with an internal temperature of 59 degrees Fahrenheit, and not the necessary 40 degrees Fahrenheit or below. In an interview conducted on 08/20/2025 at 12:00 PM, with the facility’s Clinical Manager, she was told of the findings.”

“PA-FREQUENCY REASSESSMENT-UNSTABLE Q MO CFR(s): 494.80(d)(2) In accordance with the standards specified in paragraphs (a)(1) through (a)(13) of this section, a comprehensive reassessment of each patient and a revision of the plan of care must be conducted- At least monthly for unstable patients including, but not limited to, patients with the following: (i) Extended or frequent hospitalizations; (ii) Marked deterioration in health status; (iii) Significant change in psychosocial needs; or (iv) Concurrent poor nutritional status, unmanaged anemia and inadequate dialysis. This Standard is not met as evidenced by: 40153 Based on interviews and record review, the facility failed to complete a monthly unstable care plan for 1 of 10 patients reviewed (Patient #3). The findings included: A review of the facility’s policy titled “Comprehensive Interdisciplinary Assessment and Plan of Care” dated 07/03/2023 showed the following: the following are unstable criteria: extended or frequent hospitalization of more than 15 days. A chart review revealed that Patient #3 started in-house hemodialysis on 01/18/2025. Patient #3 was hospitalized from 04/22/2025 to 05/09/2025 for nausea and vomiting. This showed Patient #3 was hospitalized over 15 days. A review of the records revealed that a 90-day care plan was completed on 05/21/2025 and an unstable care plan was completed on 07/21/25. No unstable care plan was completed monthly after Patient #3 was hospitalized from 04/22/2025 to 05/09/2025. In an interview conducted on 08/20/2025 at 12:00 PM, with the facility’s Clinical Manager, she was told of the findings.”