Fmc Dialysis Assoc. of Smyrna

“IC-SANITARY ENVIRONMENT CFR(s): 494.30 The dialysis facility must provide and monitor a sanitary environment to minimize the transmission of infectious agents within and between the unit and any adjacent hospital or other public areas. This Standard is not met as evidenced by: 46831 Based on observation and interview, the facility failed to provide and monitor a sanitary environment to minimize the transmission of infectious agents between the unit and the waiting area for 28 residents. The finding included: 1. Observations in the waiting area on 4/14/2024 at 11:35 AM, revealed the treatment room door was wide open, and no receptionist was at the front desk. The surveyor stood at the front desk for approximately 5 minutes when a patient came out through the open door. The patient went back through the open door and notified staff there was a visitor outside. RN #1 came to the door and the surveyor notified her of the complaint survey. RN #1 turned back around and headed back to the treatment area without closing the door. She yelled out to another staff member, “Close the door right now. The State is in the building.” CCHT #1 came outside the door, dressed in full PPE, reached above the door fame to hit the switch for the door to close, then entered back into the treatment area. At approximately 11:40 AM, RN #2 escorted a patient out the treatment room door wearing a gown and gloves and returned to the treatment area. There were 28 patients receiving hemodialysis treatment on the treatment floor. 2. During an interview on 4/15/2025 at 11:00 AM, RN #1 stated, “...I met you at the door ...the door should have not been open...I should have closed the door...[named] CCHT #1and RN #2 should not have come out of the treatment area without taking their PPE off...” During a telephone interview on 4/15/2025 at 4:22 PM, RN #2 stated the treatment room door was open when the surveyor arrived at the clinic. When asked about exiting the treatment area and entering into the waiting area with PPE on, RN #2 stated, “...I had on my gown and gloves...that was an infection control issue...they should have been removed before bringing the patient out of the treatment area...” During a telephone interview on 4/16/2025 at 4:30 PM, the CM stated the treatment area door should never be left open. The open door could cause infection control issues related to cross contamination. During an interview on 4/17/2025 at 9:49 AM, CCHT #1 stated, “...I opened the door for a patient in a wheelchair...there was another patient coming on a stretcher...the door should not have been left open ...it is a security, privacy, and infection control issue...” CCHT #1 then stated he should have not come out of the treatment area with PPE on.”

“PE-SAFE/FUNCTIONAL/COMFORTABLE ENVIRONMENT CFR(s): 494.60 The dialysis facility must be designed, constructed, equipped, and maintained to provide dialysis patients, staff, and the public a safe, functional, and comfortable treatment environment. This Standard is not met as evidenced by: 46831 Based on observation and interview, the facility failed to provide patients and staff a safe treatment environment when the treatment area door was left propped open allowing the potential entry of unauthorized individuals for 28 patients. The findings included: 1. Observations in the waiting area on 4/14/2025 at 11:35 AM, revealed a wide-open treatment area door with staff unaware of the surveyor’s presence. The surveyor went unnoticed for approximately 5 minutes until a patient exited the treatment area through the open door. There were 28 patients receiving hemodialysis treatment on the treatment floor. 2. During an interview on 4/15/2025 at 11:00 AM, RN #1 stated the door between the waiting area and the treatment area should have not been open. During a telephone interview on 4/16/2025 at 4:30 PM, the CM stated the treatment area door should never be left open. The CM stated that the open door left patients vulnerable and at a safety risk. During an interview on 4/17/2025 at 9:49 AM, CCHT #1 stated he opened the door earlier but should have closed it after bringing a patient into the treatment area. He stated his actions caused a security concern for the patients.”

“PR-PRIVACY & CONFIDENTIALITY-TREATMENT CFR(s): 494.70(a)(3) The patient has the right to- (3) Privacy and confidentiality in all aspects of treatment; This Standard is not met as evidenced by: 46831 Based on observation and interview, the facility failed to provide privacy and confidentiality for 28 patients receiving hemodialyisis treatment. The findings included: 1. Observations in the waiting area on 4/14/2025 at 11:35 AM, revealed a wide-open treatment area door where patients were observed receiving hemodialysis and staff was working. The surveyor observed for approximately 5 minutes until a patient exited the treatment area through the open door and notified RN #1. There were 28 patients receiving hemodialysis treatment on the treatment floor. 2. During an interview on 4/15/2025 at 11:00 AM, RN #1 stated the door between the waiting area and the treatment area should have been closed. During a telephone interview on 4/16/2025 at 4:30 PM, the CM stated the treatment area door should always be closed. An open door would violate the patients’ right to privacy. During an interview on 4/17/2025 at 9:49 AM, CCHT #1 stated he had left the treatment area door open and left patient exposed to anyone who came into the clinic.”