HospitalInspections.org

The facility failed to ensure the patient's safety by having clean and workable equipment.

Observation on 1/28/20 at 1130 revealed that two dialysis machines were present in the clean area of dialysis storage and that they were overtly soiled and one (AX115)was covered in rust on the back panel.

Observation: on 1/28/20 at 1130 it was noted that machine AX115 was out of order. the machines hours were set at 0000 with rust and the back panel fell off when touched.

In an Interview with the owner of Axis on 1/28/20 at 1140, When he was shown the condition of both machines. He said, "he was very upset". He said the staff should have cleaned the machine and taken out the Machine that was not in working order.

The facility failed to have Quapi Program focused on dialysis.

Record review of the facility's Quapi Program on 1/30/20 showed the facility failed to gather data on adverse outcomes from dialysis, Infection rates for catheters and Patient's treatments with early termination times and reason.

The facility failed to ensure that a registered nurse supervised and evaluated the nursing care for each patient by 10 out of 10 (1,2,3,4,5,6,7,8,9,10) patients not having an RN supervise dialysis treatments.

Record Review of patients (1,2,3,4,5,6,7,8,9,10) on 1/28/20 revealed that a LVN performed dialysis treatments on all 10 patients, the Registered Nurse was unaware that she was suppose to supervise the patient while recieving dialysis and direct the LVN.

In an Interview with the owner of Axis, Inc. on 1/29/20 at 1300 he stated that the dialysis nurse does not have to be a RN as the floor nurse is an RN. when asked if the RN was trained in dialysis he said, "I don't Know".

In an Interview with the CNO on 1/29/20 at 1330 she was asked when does the RN intervene or assess the patient or direct the LVN, she said the RN does not. When asked if the Nurses are trained in dialysis, she again said, "No, and added that is why we contracted dialysis out, because our staff is not trained in dialysis. We did not realize the dialysis nurse should be a RN.

The Facility failed to ensure adequate staffing for its dialysis patients being cared for by an LVN.

Record review of 10 dialysis patients (1,2,3,4,5,6,7,8,9,10) revealed that the contract staff (LVN) was not being supervised by an RN.

In an Interview with the owner of Axis, Inc. on 1/29/20 at 1300 he stated that the dialysis nurse does not have to be a
RN as the floor nurse is an RN. when asked if the RN was trained in dialysis he said, "I don't Know".

In an Interview with the CNO on 1/29/20 at 1330 she was asked when does the RN intervene or assess the patient or direct the LVN, she said the RN does not. When asked if the Nurses are trained in dialysis, she again said, "No, and added that is why we contracted dialysis out, because our staff is not trained in dialysis. We did not realize the dialysis nurse should be a RN.