Fkc Huntingdon

“PA-ASSESS B/P, FLUID MANAGEMENT NEEDS CFR(s): 494.80(a)(2) The patient’s comprehensive assessment must include, but is not limited to, the following: Blood pressure, and fluid management needs. This Standard is not met as evidenced by: 39848 Based on review of policies and procedures,medical records (MR), and interviews with facility clinical manager and facility administrator, it was determined that the facility failed to adequately monitor blood pressures and pulses during treatment for three (3) of three (3) MR reviewed. (MR # 1- # 3) Findings include: Review of Fresenius Kidney Care Clinical services patient assessment and monitoring on 2/16/24 at approximately 1:25 PM revealed: “ Pre-treatment assessment and data collection: Direct patient care staff may collect pre-treatment weight, blood pressure (BP), access, and complaints reported by the patient. Monitoring During Treatment: Obtain blood pressure and pulse rate every thirty (30) minutes or more as needed but not to exceed forty-five (45) minutes or per state regulations ... “ ; “ Document machine parameters and safety checks every thirty (30) minutes or more often as needed but not to exceed forty-five (45) minutes or per state regulations ... “ ; “ General observation/mental status: “ Note: When leaving the treatment room, report off to another staff member to ensure patient observation and monitoring during the dialysis treatment. “ Review of medical records (MR) on 2/16/24 between 11:20 AM-1:15 PM revealed: MR # 1: Start of care (SOC): 7/24/23; Review of treatment flow sheets from 1/29/24-2/14/24 revealed: a. Treatment flow sheet from 1/29/24: Blood pressure: 136/88; pulse: 103 at 11:07 AM; next blood pressure and pulse check were completed at 12:00 PM and were Blood pressure: 130/82 and pulse: 117. (fifty-three (53) minutes between checks) b. Treatment flow sheet from 2/14/24: Blood pressure: 125/52; pulse: 54 at 10:32 AM; next blood pressure and pulse check were completed at 12:06 PM and were Blood pressure: 116/77 and pulse: 113. (One (1) hour and thirty-four (34) minutes between checks) MR # 2: Start of care (SOC):10/4/21; Review of treatment flow sheets from 1/29/24-2/14/24 revealed: a. Treatment flow sheet from 2/5/24: Blood pressure: 133/49; pulse: 76 at 9:03 AM; next blood pressure and pulse check were completed at 10:02 AM and were blood pressure: 141/59 and pulse: 81. (fifty-nine (59) minutes between checks) MR # 3: Start of care (SOC): 6/2/21; Review of treatment flow sheets from 1/29/24-2/14/24 revealed: a. Treatment flow sheet from 2/9/24: Blood pressure: 94/57; pulse: 64 at 10:31 AM next blood pressure and pulse check were completed at 11:33 AM and were blood pressure: 124/57 and pulse: 68. (one (1) hour and two (2) minutes between checks) An interview with the Facility Administrator and clinical manager on 2/16/24 at approximately 1:30 PM confirmed the above findings.”

“POC-ACHIEVE ADEQUATE CLEARANCE CFR(s): 494.90(a)(1) Achieve and sustain the prescribed dose of dialysis to meet a hemodialysis Kt/V of at least 1.2 and a peritoneal dialysis weekly Kt/V of at least 1.7 or meet an alternative equivalent professionally-accepted clinical practice standard for adequacy of dialysis. This Standard is not met as evidenced by: 39848 Based on review of policies and procedures, medical records (MR), and interviews with facility clinical manager and facility administrator, it was determined that the facility failed to adequately monitor prescribed blood flow during treatment in one (1) of three (3) MR reviewed. (MR # 1) Findings include: Review of Fresenius Kidney Care Clinical services patient assessment and monitoring on 2/16/24 at approximately 1:25 PM revealed: “ Document machine parameters and safety checks every thirty (30) minutes or more often as needed but not to exceed forty-five (45) minutes or per state regulations ... “ Machine parameters and extracorporeal circuit: “ Check machine settings and measurements: check prescribed blood flow is being achieved or reason is documented in medical record if unable to meet prescribed blood flow”. Review of medical records (MR) on 2/16/24 between 11:20 AM-1:15 PM revealed: MR # 1: Start of care (SOC): 7/24/23; Review of treatment flow sheets from 1/29/24-2/14/24 revealed: a. Treatment flow sheet from 2/12/24: Prescribed Blood flow rate (BFR) four hundred fifty (450); BFR from 10:11 AM through 12:17 PM: three hundred (300) with no documentation for the lower BFR (two (2) hours and six (6) minutes between checks); BFR from 12:17 PM through 12:30 PM: four hundred (400) (thirteen (13) minutes) with no documentation for the lower BFR. An interview with the Facility Administrator and clinical manager on 2/16/24 at approximately 1:30 PM confirmed the above findings.”