Failure to Maintain Ongoing Communication with Dialysis Center
Penalty
Summary
The facility failed to maintain ongoing communication and collaboration with the contracted dialysis center for a resident with end stage renal disease who was dependent on dialysis. According to facility policy, there should be weekly communication between the facility and the dialysis center, including sharing of pre- and post-dialysis weights, laboratory results, and dietary concerns. However, review of the dialysis communication binder revealed no recent communication sheets for the resident, and the facility was unable to provide any completed communication forms for the resident in question. Interviews with staff confirmed that the required communication forms were not consistently completed or returned, and there was no documentation to show that the facility followed up with the dialysis center when forms were missing. The resident reported receiving monthly reports from the dialysis facility's dietitian but was unsure if this information was shared with the facility's dietitian. The facility's dietitian technician stated that she relied on the dialysis communication forms to coordinate nutritional services and that the resident's nutritional assessment was pending due to lack of information. The DON acknowledged that the absence of documented communication increased the risk of unmet medical needs for the resident. The deficiency was identified through observation, interviews, and record review, which demonstrated a lack of adherence to the facility's own policy and procedures regarding dialysis care communication.