RAI Chula Vista

What is Quality Safe Care?

Is this the type of care that you would want to receive,

 or you would want a loved on to receive?

The following is the facility's Recertification Survey conducted on 7/8/2010. According to the CMS data, obtained by Propublica, the last survey date was 2003. This survey had a patient sample size of 15 patients. The facility's census was 180.

The facility had an Immediate Jeopardy called because staff were providing care to patients who were hepatitis B positive while, at the same time, caring for patients who were susceptible.  The CD stated   ".... that the patients' Hepatitis B status was not taken into consideration when she made the seating schedule and staff assignments". This oversight, as we see it, placed patients in harms way. This situation happens more than we would like to realize and places patients in situations of potential transmission of infections. Of greater concern in this facility is that "The facility also failed to refer a Hepatitis B+ staff member to a physician, for follow up, after they were aware she was positive for Hepatitis B, per their P & P" (policy and procedure). Additional infection control deficiencies, including a physician who did not implement effective infection control practices, (his comment was, "I should have washed my hands"), along with other deficiencies -->  "The cumulative effect of these systemic problems resulted in the facility's inability to ensure that provision of quality health care in a safe environment."  Further review of this survey indicated something that is of even greater concern -> "...RN 4 was at the chair side. She documented the pre-assessment in the computer. The assessment information in the computer indicated that the patient's heart rate was regular and the respirations were "OK", and the lungs were clear. Direct observation identified that RN 4 did not listen to the patient's chest or do any other assessment of the patient."  This is serious and as a retired Registered Nurse, it is my opinion that this RN should have been reported to the Board of Registered Nursing. Why? This RN documented an assessment that could have led to a physician prescribing such that was not indicated for this patient. I wonder what the facility's policy is for such? Is this RN still working in this facility? The survey also clearly indicated that in spite of a policy/procedure stating pre/post assessments, the RN was not doing such, stating, that she "... routinely did not listen to a patient's heart and lungs post treatment, unless the patient had 'problelms' " The facility was also cited for a Condition NOT being met for Governance. -> "The cumulative effects of these systemic problems resulted in the facility's inability to provide quality health care in a safe environment".  I guess that I have to ask, at this point, as I ask when I read such surveys, "Is this the care you, a provider, shareholder, or  legislator, would want to have for  yourself or a loved one?" And, further asking the providers "Is this what you consider good care? Indeed, even if outcomes e.g labs, etc are good, it is clearly the day-to-day delivery of care that really counts ... 

Keep in mind that the above is a brief overview of the facility's survey findings.

General Information: http://projects.propublica.org/dialysis/facilities/52835

The following is the 2010 Dialysis Facility Report (DFR) for this facility.
 http://propublica.s3.amazonaws.com/assets/dialysis/facility-reports/CA/2010/CA_052835_2010.pdf

It appears that this facility was formerly owned by Davita and was called Davita Mission Dialysis Center of Chula Vista. (per the 2003 DFR)