Infection Control Deficiencies at Mount Carmel Senior Living
Penalty
Summary
Mount Carmel Senior Living Community failed to correct previously identified deficiencies related to infection prevention and control, as observed during a revisit survey. The facility did not ensure an environment free from the potential spread of infection for two residents. Resident 15, who was under contact precautions for suspected C. diff infection, had inadequate disposal systems for contaminated materials. The cardboard receptacle used for disposing of gowns and gloves was porous and could not be properly disinfected, posing a risk of harboring bacteria. Additionally, a nurse aide was observed serving lunch to Resident 15 without wearing the required gown and gloves, contrary to the contact precautions in place. Resident 14, who had recently returned from a hospital stay for human metapneumovirus pneumonia, was under droplet precautions. However, the facility failed to provide appropriate disposal bins for personal protective equipment (PPE) within the resident's room. A physical therapy assistant was observed improperly handling used PPE, including carrying a contaminated glove under his arm due to the lack of disposal bins. Furthermore, a nurse aide entered Resident 14's room without wearing a gown, gloves, or mask, despite the droplet precautions, while delivering meal trays to both Resident 14 and their roommate. These observations indicate that the facility did not adhere to the required infection control protocols, as evidenced by the improper handling and disposal of PPE and the failure of staff to follow precautionary measures. The deficiencies were reviewed with the Nursing Home Administrator, highlighting ongoing non-compliance with infection prevention and control standards.
Plan Of Correction
Unable to correct the issue identified regarding Resident 15 related to a staff member not wearing proper PPE. Unable to correct the issue identified regarding Resident 14 related to a staff member not wearing Proper PPE. Isolation bins were put in Resident 14's room at the time of survey. New isolation bins with foot pedals have been ordered. A Facility sweep will be conducted to identify residents on any type of precautions to ensure proper protocols are in place (signage, isolation bins, etc.). Staff will be educated on the PPE requirements for the different types of isolation/precautions (ex. Contact, Droplet, Enhanced Barrier Precautions). Audits will be conducted by the IP/Designee weekly x 4 weeks, then monthly x 2 months for compliance with the applicable isolation protocols. Results of the audits will be reviewed at the monthly QAPI meetings.