“ I Don’t Know About This?”( A Patient’s Initial Dialysis Treatment) Pt. 19 … Medicare and State Compliance Survey featuring Elisia Marchena

A.W. — Who is that young lady over there with the clipboard? She looks like she is about her business, haha! I noticed earlier when we walked in before I sat down.

D.W. — Yes she is! We are being surveyed today by the Department of Health. She is here doing a Medicare and State Compliance survey. You will see her throughout the day, looking through cabinets, checking our medications and basically observing what we do on the treatment floor and how we care for you all. She’s also a part of our Education Department, we have also worked alongside each other on a few different occasions. She and I actually meet with New Hires monthly to tell them about our Kidney Trail Koulture.

A.W. — Oh, well I need to let her know that you all do an excellent job here! She can wrap up her stuff early because she won’t find any nonsense around here!

DW — We all wish it were that easy. Medicare is the main reason why we are able to take care of our patients; they pay for most of the treatments, so they want to ensure that you all are truly getting the best care possible. Wait, here she comes. I will be back shortly.

DW- Elisia how’s everything going? I see you are making your rounds on the treatment floor today. 

E.M. — Yes, hello Dwelyn. How’s your day going? Well , I hope. 

DW — I see you made your way over to Pod Jamaica Mon!!, please let me know if there is anything I can do for you. I’m gonna leave you here and let you introduce yourself to our new patient. AW ,it’s her first day.

E.M. — I sure will, thank you kindly. By her being new to the establishment. Her feedback will be very much appreciated. Thanks again Dwelyn, I’ll see later on throughout the day.

A.W. — Excuse me, ma’am. May I talk to you?

E.M. — Absolutely! How may I help you?

A.W. — I just want you to know that everyone here is very nice. They take excellent care of me. I’ve had so many questions since I started dialysis and everyone is so knowledgeable, patient, and kind. You have no reason to give them a hard time today!

E.M. — Thank you so much for sharing that with me. May I ask, what is your name?

A.W. — My name is AW. 

E.M. — It is a pleasure to meet you, my name is Elisia. I can assure you that my intention is not to give the staff a hard time. I understand how difficult it is on the team when a surveyor is in the building. 

A.W. So what exactly do you do Elisia?

E.M. — Well, several things. I arrived here this morning and the first thing I do upon arrival is to let CMS know that I am on-site at a facility, and I need certain information from them in order to conduct the survey. They usually respond with the information by the following day. I then meet with the clinic manager or facility administrator and let them know the reason for my visit. I will be here for 3 days conducting a Medicare and State Compliance survey. 

A.W. — Oh, are those two surveys?

E.M. — Yes it is.  The two surveys are very similar, yet conducted based on two different rule sets. Medicare has rules that apply to every state, and State rules are specific to Arizona. 

A.W. — Oh I see. So what are you looking for and what are you writing down on that little clipboard you got there?

E.M. — Well, usually I begin the survey on the treatment floor. I am checking specifically for good infection control practices which include no expired medications or supplies, frequent handwashing and glove changing to name a few. I am also ensuring that you and all the patients are safe which means your access must be uncovered, your lines must be visible, and your eyes must be visible as well. 

A.W. — That makes sense. The staff here always tell me to wash my hands when I arrive and when I leave. I always tell them that they don’t have to tell me that because I know that there are all kinds of germs out there and the last thing I want is to get sick because of my own negligence.

E.M. — I commend you for taking your health into your own hands! That is excellent that the staff encourages you to wash your hands, and thank you for letting me know. 

A.W. — So what else are you looking for here?

E.M. — I will also interview a few patients and staff. If you don’t mind AW, I would like to ask you a few questions as well a little later. Would that be ok?

A.W. — Yes of course!

E.M. — Great, thank you! I also observe specific practices such as catheter care, and the staff’s overall infection control practices. Sometimes you will see me walking around or sitting down. I am watching everything they are doing from start to finish. I have to ensure that before I assume anything, I know all the facts because I’ve observed the action from start to finish, simultaneously writing down notes, times, and who I’ve observed. I will leave the floor for a few hours, and usually I will return during turnover. Day 1 of the survey is a lot of floor observations. Day 2 is some floor observations but also a lot of paperwork.

A.W. — Paperwork? Are you looking at our charts?

E.M. — Yes ma’am. Legally, any CMS and other regulatory entities are entitled to review patient medical records. It is a part of your admissions for the facility to disclose this information to you.

A.W. — I don’t know, perhaps they did. I signed a lot of papers the first day I came here.

E.M. — Yes, I understand. I will review your treatment sheets making sure that all the documentation is accurate and true. Also, I will look at your doctor’s orders and look to see that all the orders are being followed, and your treatment sheet reflects the same information as your prescription for dialysis. 

A.W. — Wow, that is a lot of work you have on your plate! Well I’m going to take a nap now. When will you be over here to ask your questions?

E.M. — I will come back in about an hour if that is alright with you?

A.W. — Yes, that works with me!

Published by DiabeTech77

Hello to all of you our wonderful Kidney Trail Hikers . My name is Dwelyn Williams, CCHT, Immediate Past President NANT . I would like to say Thank You for joining us on The Kidney Trails. A brief story of who I am . I started my Hemodialysis Technician career in January of 2000 in Charlotte,NC. During that time and now the present I have been a Traveling Hemodialysis Technician, a Chronic Preceptor, an Acute Preceptor, Kidney Smart Educator, proud NANT Board Member , and a Hemodialysis Technician Instructor. My current status is a proud employee of Fresenius Kidney Care- Arcadia as a Hemodialysis Technician CCHT/VAM and also an Acute Hemodialysis Technician here in the Phoenix, Arizona area. My involvement with dialysis goes back as far as the early 90’s. My mother was a ESRD patient during that time. We as a family contributed to her well being by assisting her with CAPD at home. After a year of doing a home modality, she ventured out into outpatient dialysis in a chronic setting of hemodialysis. With that being said , I developed not only a interest I dialysis but an extreme curiosity of what this disease was and its effect on my mother and our family. This placed a heavy matter on me due to the fact that it was beyond personal and it could happen to any of our loved ones. Serving as a NANT member and on the NANT Board has aloud me to express my concern and issues amongst others. The ability to possibly influence others. To share my passion within my profession alongside developing my craft. My goal is to encourage every Nephrology Clinical Technician that they are important in more ways than one, and to know that they matter in our patients lives. I hope to inspire more Nephrology Clinical Technicians to take on more leadership roles in their communities, clinics, and NANT. As a newly Author and Kidney Trails Family member it’s is my duty to deliver the most epic and profound stories of my vision of Renal World. What a great time none other than during this tough time we are having in the world today being impacted by the COVID 19/ Coronavirus. We hope as you hike with us along The Kidney Trails , that each step we take is with Essential Potential.

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