Based on interview, observation and record review, it was confirmed the facility failed to ensure reasonable precautions were in place in regard to infection control. Findings include:
During separate interviews with Staff #1-11, it was stated that MCC staff enter the building and screen in directly to the MCC.
On 1/14/21, Compliance Specialist (CS) observed both the MCC and the RCF staff entrances. Staff #11 was observed entering the building to start his/her shift with their eye protection already on. Staff # 9 was observed in the main entrance office area without eye protection on. The MCC does not have a disinfection station, hand sanitizer, or a PPE storage area near the separate MCC staff entrance. A random face shield was sitting on a bench (not in a storage bag) at the staff entrance to the MCC.
Review of MCC screening documents reveal staff members onsite did not screen in prior to entering the facility.
The above findings were discussed with Staff #1-5 during exit conference.
Based on interview and record review, it was confirmed the facility failed to ensure medications were carried out as prescribed. Findings include:
On 1/14/21, Compliance Specialist (CS) reviewed 1/2021 MAR for multiple residents (Residents #1-5, #7, #8) which revealed medications/treatments are not given/performed as ordered. Multiple medications were not given and documented as the facility not having them onsite.
Resident #7 had an order for a cream to be applied and then resident had to have a daily shower during treatment period. Creams were documented as only applied to partial areas, and daily showers were not given. .
During separate interview with Witness #1 and Staff #6, it was stated that creams are not always applied to all affected areas and showers were not given as ordered by a physician as part of the medication order, some days due to "staffing emergencies". This CS was told a "staffing emergency" meant there were not enough staff to perform all of the required needs of residents.
Based on interview, observation and record review, it was confirmed the facility failed to ensure adequate staff to meet residents scheduled and unscheduled needs. Findings include:
On 1/14/21 Compliance Specialist (CS) observed staff on the unit and reviewed posted staffing plan and staff schedules, with discrepancies noted. This CS observed a resident call for help for over 20 minutes prior to CS intervening to have staff respond.
During separate interviews with Staff #1-11, it was stated that there was a "staffing emergency" today and that there are not enough staff to give residents showers.
The above findings were discussed with Staff #1-5 during exit conference.
