cms_WV: 10753
Data source: Big Local News · About: big-local-datasette
| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 10753 | TRINITY HEALTH CARE OF MINGO | 515069 | 100 HILLCREST DRIVE | WILLIAMSON | WV | 25661 | 2009-06-25 | 441 | F | 0 | 1 | 667111 | Based on a review of the facility's policies and procedures for infection control and isolation for residents with infections, observations of residents with infections, and staff interview, the facility failed to develop and implement an effective infection control program to prevent the potential spread of infections in the facility. The facility's policies and procedures were not periodically reviewed and revised to reflect changes in standards of practice, and the existing procedures were not consistently implemented to prevent the spread of infectious organisms. The facility's did not maintain a record of all residents with infections, including the infectious organism found and/or the type of isolation precaution to be used. The number of residents at the facility with facility-acquired (nosocomial) infections had increased, but there was no evidence to show the facility investigated this increase in nosocomial infections for the causative factors or implemented measures to prevent further incidents of residents contracting nosocomial infections. The absence of an effective infection control program placed all residents residing in the facility at risk of acquiring an infection. Facility census: 75. Findings include: a) Infection Control Program Review of the facility's infection control policies and procedures revealed the policies were not thorough and were not consistently implemented. The infection control policy (which did not contain an effective date) stated the purpose of the policy was to ensure the infection control program was effective for investigating, controlling, and preventing infections in order to provide a safe sanitary, and comfortable environment. The procedure for this stated the following: "1. LPN (Licensed Practical Nurse) on duty will report any signs / symptoms of infection to the physician. Along with any other information requested. "2. Obtain order for treatment. Check ER (emergency) box to see if medication ordered can be obtained. If not STAT medication to facility. "3. Notify the responsible party of resident's condition and what is being done. "4. Monitor resident frequently at least each shift for three (3) days. Report any change in condition to the physician and the POA (power of attorney). "5. The Infection Contort nurse completes a monthly tracking and report sheet." This was the entire policy on infection control. There was no evidence the facility's infection control program was periodically reviewed or revised to reflect current, nationally recognized standards of practice established by the Centers for Disease Control and Prevention (CDC) and/or the Association for Professionals in Infection Control and Epidemiology (APIC). The facility's policies did not include measures to assure the cause of an infection was investigated and appropriate transmission-based precautions were implemented to control the spread of the infectious organism. A review of the facility's isolation practices revealed the existing policies and procedures were not consistently implemented. (See also citation at F442.) For example: - Resident #32 returned from the hospital with methicillin-resistant Staphylococcus aureus (MRSA) in her eyes and nares. This resident was not added to the infection control log for tracking, analysis, and trending. She was not placed in any form of isolation, and precautions to prevent the spread of this infectious organism to others were not implemented. - Resident #26 was in isolation, and the sign on his door stated "strict isolation". This resident had MRSA in a wound on his heel, and the infectious wound drainage was contained in a dressing. The facility was serving his meals on paper plates utilizing disposable dinnerware and keeping his door closed, when the resident only required contact precautions. The facility's policies concerning the types of precautions to be used were unclear. The policy for contact precautions stated these precautions shall be used in addition to standard precautions for residents with specific infections that can be transmitted by direct and indirect contact. This policy indicated gloves should be worn when entering the room. Further review of the policies indicated standard precautions were to be used in the care of all residents, including residents with MRSA. According to the facility's policy, "Isolation of residents with MRSA in long term care facility's (i.e. contact precautions) is generally not necessary." During this survey, observation found residents were required to keep the corridor door shut with a sign on the door announcing strict isolation, and nursing assistants and housekeeping staff were directed to wear personal protective equipment (including gloves, masks, and gowns) even if they were not going to come in contact with the resident. According to facility policy, isolation trash and linen were to be handled in the same manner as all trash and linen in the facility, yet there were two (2) very large barrels in the room of one (1) resident in isolation for the containment of trash and linens due to this resident having MRSA. A review of the facility's infection control surveillance data found that, in the month of April 2009, there were ten (10) nosocomial infections in the facility on three (3) halls. In the month of May 2009, there were eighteen (18) residents with nosocomial infections on the 100 and 200 halls, and no data were available regarding residents on the 300 hall. The facility's total census at the time of this survey was seventy five (75). With eighteen (18) affected residents, twenty-four percent (24%) of the facility's census had nosocomial infections. These surveillance data were recorded on the infection control logs, but there was no evidence the facility investigated the cause of these infections (examples: possible transmission during wound care, catheter care, perineal care, the administration of eye drops, etc.). The assistant director of nursing (ADON - Employee #46), when interviewed about the facility's infection control program on the afternoon of 06/24/09, confirmed that what was provided to the survey team was all that was written. When questioned about the facility's isolation policies, the ADON acknowledged not knowing that Resident #32 had a MRSA infection and confirmed that isolation procedures were not always implemented as written. She stated they call the doctor and then do what the doctor tells them to do as far as isolation. . | 2014-12-01 |