Davita Longview Dialysis Center

“IC-SINKS AVAILABLE CFR(s): 494.30(a)(1)(i) A sufficient number of sinks with warm water and soap should be available to facilitate hand washing. This Standard is not met as evidenced by: 48653 Based on observation, record review, and interview, the facility staff failed to ensure 3 (laboratory sink # 1 and # 2 and medication sink # 1) of 3 sinks located in the in-center treatment area had hand soap available to facilitate handwashing among the patients and staff members at the facility. Also, the facility staff failed to follow the facility policy titled, “INFECTION CONTROL FOR DIALYSIS FACILITIES”. This deficient practice had the likelihood to cause harm to patients, staff members, and the public by increasing the risk of transmission of infectious agents within the facility. During a tour of the in-center treatment area with Staff # 7 on 02/20/2025 at 10:00 AM the surveyor observed the following: The handwashing sinks did not contain hand soap to facilitate handwashing. Soap and a supply of paper towels protected from contamination must be available at each sink. According to the CDC (Centers for Disease Control), “Healthcare facilities should ensure that supplies necessary for adherence to hand hygiene are readily accessible in all areas where patient care is being delivered. Hand Hygiene means cleaning your hands by using either handwashing (washing hands with soap and hot water), antiseptic hand wash, antiseptic hand rub (i.e. alcohol-based hand sanitizer including foam or gel),or surgical hand antisepsis.” A review of facility policy, “INFECTION CONTROL FOR DIALYSIS FACILITIES” with a revision date of October 2022 revealed, “”PURPOSE: To minimize the spread of infections or bloodborne pathogens in the dialysis facility environment. POLICY: The Centers for Disease Control (CDC) Recommendations for preventing transmission of infections among Chronic Hemodialysis Patients will be followed when caring for all patients ... 39. Sinks should be easily accessible and readily available in the treatment area and in other appropriate areas such as the medication area, home training room, and isolation area/room. Sinks must be plumbed with both hot and cold water. Clean sinks should be dedicated to clean activities such as hand washing and remain clean... The facility should have a sink available for patients to wash their access sites prior to treatment and their hands after treatment. The sink may also be used by teammates for handwashing. Soap and a supply of paper towels protected from contamination must be available at each clean sink...” In an interview with Staff # 7 on 02/20/2025 at 10:15 AM, Staff # 7 confirmed there were 3 sinks located in the in-center treatment area that did not have hand soap present at the sink.”

“CFC-PATIENT ASSESSMENT CFR(s): 494.80 This Condition is not met as evidenced by: 29191 Based on observation, record review, and interview, the facility’s staff failed to evaluate the appropriateness of the dialysis prescription, for 1 of 1 patient (patient #1). The patient was prescribed 1.0 K, 2.25 Ca, and the patient received 2.0 K 2.25 Ca. dialysate. The facility staff failed to verify the ordered prescription matched the prescription the patient was receiving before treatment initiation. Also, the facility staff failed to follow the facility policy titled, “Pre-Intra-Post Treatment Data Collection, Monitoring, and Nursing Assessment”. Creoss refer to tag V 503”

“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: 48653 Based on observation, policy review, and staff interview, the facility staff failed to change gloves and perform hand hygiene between patient encounters and before touching dialysis equipment and sterile supplies. The facility staff failed to follow the facility policy titled, “INFECTION CONTROL FOR DIALYSIS FACILITIES”. Findings include: During a tour of the facility’s in-center treatment area with Staff # 1 on 11/02/2023 at 11:00 AM, the surveyor observed Staff # 18 don a pair of gloves at patient # 2’s dialysis station. Staff # 18 touched the dialysis machine and computer stand and proceeded to walk over to the counter which contained sterile supplies. Staff # 18 reached inside the drawer containing sterile supplies with the same gloves on. Staff # 18 then adjusted her eye protection and walked to patient # 1’s dialysis station. Staff # 18 never changed gloves or did hand hygiene between the patient encounters and before touching dialysis equipment and sterile supplies. A review of facility policy titled, “INFECTION CONTROL FOR DIALYSIS FACILITIES” with a revision date of April 2023 revealed, PURPOSE: To minimize the spread of infections or bloodborne pathogens in the dialysis facility environment. POLICY: The Centers for Disease Control (CDC) Recommendations for Preventing Transmission of Infections among Chronic Hemodialysis Patients (Dialysis Precautions) will be followed when caring for all patients ... HAND HYGEINE 1. All teammates, Physicians and Non-Physician (NPP) will perform hand hygiene a. upon entering and exiting the patient treatment area, b. prior to gloving and immediately after removal of gloves, c. after contamination with blood or other infectious material, d. after patient and dialysis delivery system contact, e. after interacting with wall boxes (i.e., plugging/unplugging acid/bicarb lines form dialysis machine, changing acid types, when exchanging a dialysis machine) f. between patients even if the contact is casual, g. before touching clean areas such as supplies, supply cart and chairside keyboard/mouse 2. Patients and caregivers will be encouraged to a. Wash their hands and access extremity upon entering the treatment area prior to the initiation of dialysis. b. Perform hand hygiene after treatment before leaving treatment area. PPE (i.e., gown, gloves, eye protection, face shield) 5. Appropriate PPE will be worn whenever there is the potential for contact with body fluids, hazardous chemicals, contaminated equipment and environmental surfaces, for example, patient care areas. PPE is to be: a. Removed prior to leaving the treatment area. b. Removed as soon as possible if overtly contaminated and i. Disposable, deposit in a biohazard waste container ii. Non-disposable, properly disinfect and place in designated area c. PPE is not to be worn in non-treatment areas, for example, teammate lounge, teammate offices.” An interview with Staff # 1 on 11/02/2023 at 11:45 AM confirmed Staff # 18 did not change gloves and complete hand hygiene at the appropriate times and intervals as required in the facility policy, “Infection control for dialysis facilities”.”