Fmc - Coral Gables LLC

“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: 53121 Based on observations, interviews and reviews, the facility failed to ensure that a Registered Nurse (RN) practiced proper hand hygiene during the initiation of dialysis treatment via an Arteriovenous Fistula (AVF) and failed to ensure patients performed hand hygiene after dialysis treatments. This was identified in 2 out of 10 sampled patients reviewed (Patient #10 and Patient #7). The findings included: A review of the facility’s policy titled “Hand hygiene” dated 03/20/2013 revealed that it included but was not limited to the following: the purpose of this policy is to prevent transmission of pathogenic microorganisms to patients and staff thought cross-contamination. The policy requires hands to be cleaned before performing any connections and disconnections. 1. A record review revealed that Patient #10 was admitted to home hemodialysis on 08/07/2025. An observation conducted on 09/18/2025 at 10:00 AM revealed Staff D/ RN was initiating dialysis treatment for Patient #10 via an AVF at station #2. Staff D/RN was observed cleaning his hands, donning a pair of clean gloves, and adjusting his face shield before touching the access site. Further observation revealed that Staff D/RN did not remove his gloves or perform hand hygiene after touching his face-shield. During an interview conducted on 09/18/2025 at 11:50 AM, Staff D/RN acknowledged the above findings and stated that he is required to wash his hands before patient contact and that he must remove his gloves and perform hand hygiene if he touches any other surfaces. 2. A record review revealed that Patient #7 was admitted to the facility on 09/02/2025 for home hemodialysis. An observation conducted on 09/16/2025 at 10:06 AM, showed Patient #7 completed his dialysis treatment at station #5. Continued observation revealed that Patient #7 did not wash his hands following the dialysis treatment and Staff D/RN did not instruct or encourage him to perform hand hygiene. In an interview conducted on 09/16/2025 at 10:19 AM, Staff D/RN acknowledged that he did not instruct or encourage Patient #7 to wash his hands after the dialysis treatment.”

“IC-HANDLING INFECTIOUS WASTE CFR(s): 494.30(a)(4)(i) [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- (i) Handling, storage and disposal of potentially infectious waste; This Standard is not met as evidenced by: 53121 Based on observations, interviews and record reviews, the facility failed to ensure the proper disposal of the bloody sharp syringes into an appropriate biohazard container for 1 of 10 sampled patients. Patient #10. The findings included: 1. A review of the facility’s policy titled “Medical Waste Protocol” reviewed on 05/28/2025 showed it included but was not limited to the following: needles, syringes, lancets and broker glass contaminated with blood or bloody fluids go in the sharp container box. 2. A record review revealed that Patient #10 was admitted to home hemodialysis on 08/07/2025. Observation conducted on 09/18/2025 at 10:00 AM revealed Staff D, Registered Nurse (RN) was initiating dialysis treatment via an Arteriovenous Fistula (AVF) for Patient #10 at station #2. Staff D/ RN was educating Patient #10’s family member on home hemodialysis procedures. During this observation, the family member flushed the access site and redrew the needle which contained visible blood. The family member disposed of the syringe in a regular trash bin instead of a designated biohazard container. Continued observation showed the same family member administering Heparin to Patient #10 under Staff D/RN’s instruction. After administering the medication, the family member again failed to dispose of the syringe in a designated biohazard container. In an interview conducted on 09/18/2025, at 11:50 AM, Staff D/RN stated that because Patient #10 would only have one biohazard bag at home, he did not instruct the family member to discard the bloody syringe in the appropriate biohazard container.”