Fmc Dialysis Services of Abilene South

“PE-BUILDING-CONSTRUCT/MAINTAIN FOR SAFETY CFR(s): 494.60(a) The building in which dialysis services are furnished must be constructed and maintained to ensure the safety of the patients, the staff and the public. This Standard is not met as evidenced by: 30377 Based on observation and staff interview, the facility staff failed to maintain the facility free from defects and/or hazards to ensure safety and functionality. Integrity of all surfaces (floors and walls) must be intact, clean, and free from damage. Intact surface integrity allows for effective cleaning and limits the potential for microbial growth on a porous surface. In-center Treatment Floor: During a tour of the facility on 11/03/2025 at 2:30 PM there were defects noted on the in-center treatment floor. * Multiple chase walls below the wall boxes were observed severely damaged. The chase boxes were observed with exposed particle board with multiple areas where the base of the particle board were peeling up. The area could not be thoroughly disinfected between patients. Water Room: * A dried brownish red substance was observed underneath and around the base of the water heater. The dried brownish red substance appeared to be rust buildup. Interview with the Facility Manger on 11/03/2025 at 2:45 PM confirmed all the defects and hazards observed in the In-center treatment and water room.”

“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: 30377 Based on review of hemodialysis flow sheets, policy and procedures, and staff interview the facility failed to ensure that direct patient care staff reported significant changes in patient health status while receiving hemodialysis to the charge nurse and or the charge nurse failed to reassess the patient when significant changes occurred during treatment and notify the physician when appropriate. The findings included: Review of hemodialysis flow sheets on 11/04/25 in the facility conference room revealed an example of the following discrepancies: Patient #1 Flow Sheet dated 10/31/25 Dialysis Prescription Treatment Time: 3.5 hours Pre Treatment Vitals: Time: 15:02 Blood Pressure: 144/118 Heart Rate: 72 Post Treatment Vitals: Time: 18:41 Blood Pressure: 117/61 Heart Rate: 74 Treatment Initiated Time: 15:08 Blood Pressure: 128/79 Heartache 58. 17:42 Blood Pressure: 80/52 Heart Rate 64 with direct patient care technician documenting “ ....UF off per RN Rob.” There was no documentation presented at time of review that the registered nurse addressed the severe hypotension. 18:01 Blood Pressure: 80/50 Heart Rate 67 with direct patient care technician documenting “ ....RN notified ...UF off: head hurts, nausea.” There was no documentation presented at time of review that the registered nurse addressed the severe hypotension and or complaints of headache and nausea. Post Treatment Assessment: RN documented “Pt stable post tx. Leaving over EDW, no complaint upon discharge.” There was no documentation presented at time of review that the registered nurse addressed the severe hypotension, saline boluses and adjustment of the ultrafiltration during the dialysis treatment. There was not documentation presented that the registered nurse addressed the patient’s complaint of headache and nausea during the dialysis treatment. A review of the facility policy, “Reportable by Direct Patient Care Staff to Charge Nurse.” Revealed that the following parameters were provided for the direct patient care staff to give guidance when a registered nurse needed to evaluate the patient status. Intra-Dialytic Blood Pressure: Systolic: < 100 or > 180 Diastolic: < 50 or > 100 Pulse: < 60 or > 100 Temperature: < 95F or > 100F Any Complaints made by the patient An interview conducted with staff #1 on 11/04/25 following her own review of the findings revealed she was unaware of the discrepancies found in the flow sheets. Staff #1 confirmed the above findings.”