Failure to Perform Hand Hygiene During Meal Service
Penalty
Summary
Staff in the facility failed to perform required hand hygiene (HH) during meal service in one of two observed dining rooms. Multiple instances were observed where staff, including agency nursing assistants and other personnel, placed clothing protectors on residents, touched residents' hair, neck, clothing, wheelchairs, and other surfaces, and then proceeded to interact with other residents or handle food items without completing HH in between these activities. Specific examples included staff touching residents and their wheelchairs, handling clothing protectors, and serving or assisting with food and beverages without performing HH as required by professional standards and facility policy. Interviews with staff confirmed their awareness of the HH requirements, including the need to perform HH after touching residents, wheelchairs, or clothing, and before handling food. Despite this knowledge, observations showed repeated failures to adhere to these protocols during the meal service. These actions were directly observed and documented by surveyors, and the deficiency was cited under the relevant state regulations.