Inadequate Infection Control During Meal Service and COVID-19 Outbreak
Penalty
Summary
The deficiency involves the facility’s failure to maintain an effective infection prevention and control program, specifically related to hand hygiene, handling of drinkware and silverware, and proper mask use during a COVID-19 outbreak. Surveyors observed that one CNA went from room to room collecting and refilling residents’ water pitchers without performing hand hygiene between rooms or after handling a resident’s straw. Another CNA assisted a resident with dressing, handled multiple residents’ meal trays, and then delivered and set up room trays for other residents without performing hand hygiene between residents or after direct contact with a resident and their food. Surveyors also observed improper handling of residents’ drinkware and silverware. One CNA pulled down the outside of his mask with his bare hand to speak with a resident, then used the same unwashed hand to hold the resident’s straw while encouraging her to drink, and continued refilling other residents’ water pitchers without hand hygiene. Another CNA unwrapped a resident’s silverware and held the fork and knife by the tines and cutting surface, grabbed the resident’s coffee mug by the rim to hand it to her, later grabbed the mug by the rim again to add sugar, and used the handle of the same knife that had been used to cut food to stir the resident’s coffee. During a period when the facility was in COVID-19 outbreak status, staff were also observed not donning face masks appropriately. One CNA repeatedly pulled his mask down by grabbing the outside of it while in close proximity to a resident’s face and did not perform hand hygiene after touching the mask, and his mask did not cover his mouth and nose while he was close to the resident. Another CNA wore a surgical mask pulled down below his mouth while assisting residents to their seats in the dining room and while sitting next to and assisting a resident with eating. These practices occurred despite facility policies and staff interviews confirming that hand hygiene should be performed before and after handling masks, that masks should cover both nose and mouth during an outbreak, and that staff should avoid touching areas of cups and utensils that contact residents’ mouths.
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