Davita Taylor Dialysis

“COMPLIANCE WITH FED/STATE/LOCAL LAWS CFR(s): 494.20 The facility and its staff must operate and furnish services in compliance with applicable Federal, State, and local laws and regulations pertaining to licensure and any other relevant health and safety requirements. This Standard is not met as evidenced by: 31974 Based on review of documentation and interview, it was determined that Charge Nurses were assigned patient care duties contrary to Texas ESRD Rules and Regulations. Tour of the treatment area during the morning of 10/08/24 revealed 11 patients, 3 PCTs (Patient Care Technicians) and 1 RN/Charge Nurse. The Charge Nurse was observed providing patient care. There were 2 patients present with catheters. In an interview conducted on the morning of 1/23/24, Staff #1, the Facility Administrator stated, “There are currently 11 patients receiving treatments. We try to have 12 patients on first and second shift every Monday-Wednesday-Friday and every Tuesday-Thursday-Saturday. We have fewer than 12 patients on our 3rd shifts. We always staff 1 nurse and 3 PCTs.” Review of staffing and patient schedules for August 2024 through September 8, 2024 revealed documented evidence that the Charge Nurse administered medications and provided catheter care on all days reviewed. In an interview with the Staff #1, Facility Administrator on 1/23/24, it was admitted that the facility was staffed daily with the Charge Nurse assigned patient care duties. It was also confirmed that the facility had been previously cited for this same issue in January, 2024 and August, 2018.. During an interview on the afternoon of 10/08/24, Staff #5, the General Facility Administrator reported there are plans to add a nurse at each facility in order to comply with regulatory requirements..”

“COMPLIANCE WITH FED/STATE/LOCAL LAWS CFR(s): 494.20 The facility and its staff must operate and furnish services in compliance with applicable Federal, State, and local laws and regulations pertaining to licensure and any other relevant health and safety requirements. This Standard is not met as evidenced by: 28421 Based on review of documentation and interview, it was determined that Charge Nurses were assigned patient care duties contrary to Texas ESRD Rules and Regulations. Tour of the treatment area during the morning of 1/23/24, revealed 9 patients, 3 PCTs (Patient Care Technicians) and 1 RN/Charge Nurse. The Charge Nurse was observed providing patient care (giving medications and initiating treatment with a catheter). In an interview conducted on the morning of 1/23/24, Staff #10, (CCHT) stated, “There are currently 9 patients receiving treatments. We are expecting 1 more patient. 1 patient is in the hospital. 2 of the patients on dialysis right now have catheters. We try to have 12 patients on the 1st and 2nd shift every Monday-Wednesday-Friday and every Tuesday-Thursday-Saturday. We have fewer than 12 patients on our 3rd shifts. We always have 1 nurse and 3 PCTs.” The Facility Administrator was interviewed on the afternoon of 1/23/24, He stated, “The only shift where we have less than 8 patients is the Tuesday-Thursday-Saturday 3rd shift.” Review of two weeks of treatment sheets for 13 of 13 patients revealed documented evidence that the Charge Nurse administered medications and provided catheter care on all days reviewed. In an interview with the Facility Administrator on 1/23/24, it was admitted that the facility was staffed daily with the Charge Nurse assigned patient care duties. It was also confirmed that the facility had been previously cited for this same issue in August of 2018.”

“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: 28421 Based on observation, it was determined that the facility failed to provide and monitor a sanitary environment. Findings were: Facility policy entitled “Infection Control for Dialysis Facilities” stated “Patients are encouraged to wash their hands and access extremity upon entering the treatment area prior to the initiation of dialysis and wash their hands after treatment before leaving treatment area.” The same policy continued “The facility should have a sink available for patients to wash their access sites prior to treatment and their hands after treatment. This sink may also be used by teammates for hand washing. Soap and a supply of paper towels protected from contamination must be available at each sink.” Tour of the patient treatment area on 1/23/24 revealed 4 patients coming onto the floor for initiation of treatment. None washed their hands or access sites. 3 patients left the treatment floor after dialysis. None of these patients were observed washing their hands after treatment. The staff did not prompt the patients to wash their hands or offer them hand sanitizer. In interviews with the Regional Home Manager and the Director of Quality on 1/23/24, the lack of hand washing by patients before and after treatment was verified.”