Failure to Maintain Infection Surveillance and Documentation
Penalty
Summary
The facility failed to implement a comprehensive infection prevention and control program for its 20 residents. Specifically, the facility did not maintain antibiotic and infection surveillance logs, and the Infection Preventionist was unable to provide any electronic or paper records documenting the collection and analysis of infection data. Instead, the Infection Preventionist relied on daily reviews of the Electronic Medical Record for new antibiotic orders and provided only verbal reports of infections and antibiotic use during Quality Assurance meetings. This practice was inconsistent with the facility's own policy, which required systematic monitoring, documentation, and analysis of infection data through a monthly infection control log and ongoing surveillance.