Failure to Readmit Resident With Candida auris Despite Facility Capability
Penalty
Summary
The deficiency involves the facility’s failure to allow a cognitively intact resident with an infectious diagnosis requiring Enhanced Barrier Precautions to return from the hospital, despite the facility’s ability to provide the necessary care. The resident had multiple diagnoses including compartment syndrome, paraplegia, generalized muscle weakness, and a need for assistance with personal care, and was frequently bowel incontinent with a urinary catheter. The resident was transferred to an acute care hospital for altered mental status, hypotension, and diarrhea, and was subsequently admitted for septic shock. While hospitalized, the resident was identified as positive for Candida auris (CA). The facility’s Infection Preventionist reported that cultures for CA were negative and stated that the facility had the ability to care for residents with CA, including having adequate PPE and staff education for contact isolation. Despite this, the DON stated that the facility was notified that the resident was positive for CA and that, based on an internal facility document and a decision made by upper management, the facility was “not a C. Auris facility” and therefore did not accept residents with CA. The DON described CA as highly contagious and cited this as the reason for not accepting the resident back. The Admissions Director reported that a family member informed her of the CA diagnosis and that she told the family the facility generally did not accept residents with CA, referencing a corporate-supplied clinical capabilities list that specified which conditions the facility could and could not manage. The facility’s refusal to readmit the resident, despite the Infection Preventionist’s statement that the facility could care for residents with CA and had appropriate resources, led to the identified deficiency related to ensuring transfers/discharges meet resident needs and preferences and preparing for a safe transfer/discharge.
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