F0836

D

Improper Denial of Admission for C. auris-Positive Resident

Jersey City, New Jersey Survey Completed on 01-15-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to comply with Federal, State, and local laws, regulations, and accepted professional standards by denying admission to a referred resident based solely on a diagnosis of Candida auris (C. auris). CDC guidance dated 4/24/24 states that transmission-based precautions (TBP) and enhanced barrier precautions (EBP) for C. auris are similar to those used for other multidrug-resistant organisms and that most facilities equipped to care for MDROs can also care for patients with C. auris. New Jersey Department of Health guidance dated 3/24/23 further specifies that most healthcare facilities can provide adequate care for C. auris-positive individuals and therefore should not deny admission based upon a C. auris diagnosis. Despite these directives, the facility’s referral list showed that one referred resident was denied admission, with the reason documented as “Medical,” which the Regional Admission Director later clarified was due to C. auris.

The resident in question had a prior admission at the facility, had been referred again from a nearby hospital, and lived in the vicinity of the facility. The Regional Admission Director explained that referrals are reviewed by an outside clinical team and the in-house admissions team, including the LNHA, and that the denial reason “Medical” in this case meant the resident had C. auris. He stated the facility did not have a dedicated C. auris unit and cited infection control and lack of isolation as the basis for the denial. However, the Infection Preventionist/Assistant DON reported that the facility admits residents on EBP and contact precautions, that staff are knowledgeable in caring for residents on these precautions, and that the facility had policies for EBP and contact precautions. The facility’s own EBP policy indicated that a private room is not required, and its infection prevention and control program policy recognized contact precautions as one of the established transmission-based precautions.

Further review showed that on the date relevant to the referral, the facility had numerous available beds, including multiple private rooms on several floors. The LNHA described the admission process as involving review of referrals by an outside clinical team and the in-house admissions team, with final decisions made on a case-by-case basis, typically denying residents deemed not appropriate such as those on ventilators. When questioned, the LNHA and Regional Nurse acknowledged that the facility had residents on EBP and contact precautions, that staff could meet the needs of such residents, and that C. auris is managed with contact precautions. The Regional Nurse also stated that another affiliated facility had a dedicated C. auris isolation unit and that the resident was directed there, while acknowledging that at the time “we did not really accept C. auris,” despite having EBP and contact precaution protocols in place. When asked why the resident was denied admission under these circumstances, the LNHA, DON, and Regional Nurse did not provide a response, establishing that the denial was inconsistent with CDC and NJ DOH guidance and the facility’s own policies.