Failure to Track and Document Resident Infection in Surveillance Logs
Penalty
Summary
The facility failed to implement appropriate tracking and surveillance of infections for two of the three months reviewed, specifically in April and May 2025. According to the facility's own infection prevention and control policy, the program is required to perform surveillance, use infection reports to improve processes, and take corrective actions as indicated. However, documentation review revealed that a resident developed eye drainage and was subsequently diagnosed and treated for bacterial conjunctivitis with antibiotic eye drops on two separate occasions during the review period. Despite these documented infections and treatments, the facility's infection tracking records for April and May did not include this resident's infection. An interview with the Infection Preventionist confirmed that the resident was diagnosed and treated for bacterial conjunctivitis, but the infection was not recorded in the facility's infection tracking logs for the relevant months. The Infection Preventionist was unable to explain how this omission occurred. This failure to accurately track and document infections is not in accordance with the facility's infection prevention and control policy and the requirements for ongoing surveillance as outlined in regulatory guidelines.