Davita Los Banon Dialysis Facility

Davita’s Los Banos Dialysis Center was opened in 1993. The facility’s last survey (inspection for recertification) was conducted in Apil 2001, therefore, ten years without an inspection to ensure the facility was in compliance with reglations. As a Dialysis Patient Advocate, I do not blame the state of California, I blame CMS. CMS, in contracting with states, needs to provide sufficient funding. It is CMS’ responsibility to ensure Medicare beneficiaries receive quality safe care.

CMS’ Dialysis Facility Compare shows that the outcomes for anemia management and dialysis adequacy in 2009 were good. However, if we look further into data provided to Propublic by CMS we learn that there might be problems with delivery of care in this facility. However, how will we know if there has not been an inspection conducted. http://www.propublica.org/topic/diagnosing-dialysis

The ‘patient death rate versus expected’ rate (first year 2006-2008) shows 37% (higher than expected). Further stated is that this number is ‘not considered statistically significantly” and recommends the viewer/reader to ’contact the facility for more information about this measure’. The same is noted for ‘patient death rate versus expeted 2006-2009’ Data shows ‘days in hospital versus expected days in hospital 2006-2008’ to be 22% (higher than expected) and for ‘hospital admissions versus expected admissions for 2006-2008’ shows 3% (higher than expected). These two aforementioned did not state that numbers were ‘not considered statistically significant, etc.”

Infection is the number two cause of death in this vulnerable population. This facility was over the national rate for “Septicemia - Percent hospitalized with a blood stream infection, 2006-2008) - Further, the facility was higher than the national rate for “Access-Related infections - Percent with vascular access infection, 2008). After reading this, I guess the next question would be directed towards the implementation of effective infection control practices. However, without an inspection, we are unclear is this is a problem, or not.

We take this a step further and review the 2010 Dialysis Facility Report for this facility (not the inspection report). http://propublica.s3.amazonaws.com/assets/dialysis/facility-reports/CA/2010/CA_052738_2010.pdf We learn the following:

For 2006, there were 63 patients and 10 deaths ---expected deaths noted at 7.5 --

There were no numbers in the report for deaths due to infection (or cardiac). However, as above, the facility was higher in their infection percentages. As we go further into the report, we find that out of 48 Medicare patients 17.4% were hospitalized with septicemia. I guess that might answer our question regarding implementation of correct infection control practices. In 2007, there were 43 Medicare patients and 20.9% were hospitalized with septicemia. In 2008, there were 49 Medicare patients and 8.2% were hospitalized with septicemia.