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F0838
D

Facility Assessment Failed to Address Hemodialysis and G-Tube Resident Needs

Fairfield, Iowa Survey Completed on 06-11-2025

Penalty

Fine: $89,300
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to ensure its Facility Assessment accurately identified and addressed the specialized staff training and supply needs for residents currently receiving hemodialysis and those receiving nutrition, hydration, and medications via a gastrostomy tube (G-tube). A review of the Resident Matrix showed that three residents were receiving hemodialysis and two residents were receiving care through a G-tube, yet the Facility Assessment did not reflect the presence of any such residents or their associated care requirements. None of these residents were new admissions, as all had been admitted more than 30 days prior to the review. During an interview, the Administrator acknowledged that specialized medical and nursing supplies, as well as staff education and training, would be necessary to care for residents with enteral feeding tubes and those receiving dialysis. The facility's policy and the Administrator both indicated that the Facility Assessment should be updated with changes in census case mix or the addition of new services, but the most recent assessment did not include the current needs of residents requiring hemodialysis or enteral feeding. This omission was identified despite the involvement of department heads, leadership, the Medical Director, and other stakeholders in the assessment process.

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