Fresenius Kidney Care Miami Park Centre

“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 observations, policy review and interviews, the facility failed to follow standard infection control precautions for 1 out of 13 sampled patients. Patient #12. Findings include: On July 9, 2025, at approximately 9:55 AM, Staff G/ Registered Nurse (RN) was observed cleaning Station 3 which had been previously used by Patient #12. The Clinical Manager (CM) was beside the surveyor. Staff G/ RN had cleaned the dialysis machine appropriately and had gotten fresh towels to clean the chair, however instead of opening the chair sides, cleaning them and then allowing them to dry, Staff G/ RN immediately closed the surfaces, not allowing them to air dry appropriately prior to closing. During an interview on July 9, 2025, the CM was asked if this was considered appropriate for returning the chair for service, he stated no. Later, Staff G/ RN stated to the surveyor that she was nervous being watched and forgot to allow the chair’s inner surfaces to remain open to dry appropriately. During an interview on July 11, 2025, at approximately 2:00 PM, the Director Operations acknowledged the above findings. A review of the facility’s Clinical Services policy Cleaning and Disinfecting the Dialyses Station Reference number 47806, Published on 09/05/2023 under section Work Surface Cleaning and Disinfection with Visible Blood <10 ml and Other Potentially Infectious Material using Bleach Solutions revealed it included but was not limited to: Make the surface glisteningly wet and let air dry unless otherwise specified by the manufacturer.”

“IC-STAFF EDUCATION-CATHETERS/CATHETER CARE CFR(s): 494.30(a)(2) Recommendations for Placement of Intravascular Catheters in Adults and Children I. Health care worker education and training A. Educate health-care workers regarding the ... appropriate infection control measures to prevent intravascular catheter-related infections. B. Assess knowledge of and adherence to guidelines periodically for all persons who manage intravascular catheters. II. Surveillance A. Monitor the catheter sites visually of individual patients. If patients have tenderness at the insertion site, fever without obvious source, or other manifestations suggesting local or BSI [blood stream infection], the dressing should be removed to allow thorough examination of the site. Central Venous Catheters, Including PICCs, Hemodialysis, and Pulmonary Artery Catheters in Adult and Pediatric Patients. VI. Catheter and catheter-site care B. Antibiotic lock solutions: Do not routinely use antibiotic lock solutions to prevent CRBSI [catheter related blood stream infections]. This Standard is not met as evidenced by: 47207 Based on observations, interviews and policy review, the facility failed to ensure that a Licensed Practical Nurse (LPN) followed the proper standard infection control precautions during the initiation of dialysis through a Central Venous Catheter (CVC) for 1 out of 13 sampled patients. Patient #7 Findings include: Staff F/ LPN was observed on July 10, 2025, at approximately 3:15 PM initiating dialysis for Patient #7. Patient #7 followed hand hygiene protocol and washed his hands prior to sitting in the dialysis chair. A mask had been provided to and applied by Patient #7 prior to starting the dialysis treatment. Patient #7’s shirt was unbuttoned to expose the CVC dressing. Staff F/ LPN did not provide ample support to the shirt to keep it from falling back onto the exposed skin and CVC site, after applying a chlorhexidine swab to the site. After Staff F/ LPN started the dialysis treatment for Patient #7, he was asked why he had not pulled the shirt back further to leave more room between the shirt and the exposed CVC area, he stated that he had made a mistake. A review of the facility’s Policy Changing the Catheter Dressing Procedure reference number 45664, published on 05/02/2025 Under section Applying the Dressing Step 1 revealed it included but was not limited to: Using aseptic technique, apply the catheter dressing over a dry exit site, being careful not to touch the patient side of the dressing with gloved hands or any other surface.”