A COVID-19 Focused Emergency Preparedness Survey was conducted by the State Survey Agency on 12/8/20 to 12/10/20.
The facility was found to be in compliance with 42 CFR 483.73 related to E-0024 (b) (6).
A COVID-19 Focused Infection Control Survey was conducted by the Oregon State Survey Agency on 12/8/20 to 12/10/20. A deficiency was cited.
Total residents: 26
Abbreviations possibly used in this document:
ADL: activities of daily living
bid: twice a day
BIMS: Brief Interview for Mental Status
CAA: Care Area Assessment
CBG: capillary blood glucose or blood sugar
cm: centimeter
CMA: Certified Medication Aide
CNA: Certified Nursing Assistant
CPR: Cardiopulmonary Resuscitation
DNS: Director of Nursing Services
F: Fahrenheit
FRI: Facility Reported Incident
HS or hs: hour of sleep
LPN: Licensed Practical Nurse
MAR: Medication Administration Record
mcg: microgram
MDS: Minimum Data Set
mg: milligram
ml: milliliters
O2 sats: oxygen saturation in the blood
OT: Occupational Therapist
PCP: Primary Care Physician
PO: by mouth, orally
PRN: as needed
PT: Physical Therapist
RA: Restorative Aide
RAI: Resident Assessment Instrument
RD: Registered Dietitian
ROM: range of motion
RN: Registered Nurse
RNCM: Registered Nurse Care Manager
SA: State Agency
SLP: Speech Language Pathologist
TAR: Treatment Administration Record
tid: three times a day
UA: Urinary Analysis
UTI: Urinary Tract Infection
A COVID-19 Focused Infection Control Revisit Survey was conducted by the Oregon State Survey Agency on 1/29/21.
The facility was found to be in compliance with 42 CFR.483.80.
Total residents: 35
Based on observation, interview and record review it was determined the facility failed to implement all infection control processes to disinfect environmental surfaces for food transportation carts, laundry and general cleaning within the facility. This placed residents and staff at increased risk for COVID-19 infection. Findings include:
Centers for Disease Control "Interim Infection Prevention and Control Recommendations for Healthcare Personnel During Coronavirus Disease 2019 (COVID-19) Pandemic" revised 7/15/20 instructed facilities to ensure environmental cleaning and disinfection procedures were followed consistently and correctly.
The disinfecting solutions (hdqC2 & SANI T-10 Plus) used within the facility had manufacturer's instructions which stated "apply solution ... so as to wet all surfaces thoroughly. Allow to remain wet for 10 minutes, then remove excess liquid."
On 12/8/20 at 11:50 AM, Staff 1 (Housekeeping Supervisor) was interviewed about disinfection of surfaces in the laundry room. Staff 1 stated she sprayed hdqC2 onto washers and dryers, leaving those surfaces wet for 2-3 minutes, then dried those surfaces.
On 12/8/20 at 12:01 PM, Staff 2 (Cook) was interviewed about disinfection of food carts used to transport food from the kitchen to the residents. Staff 2 stated she used SANI T-10 Plus to spray on surfaces of food carts, then wiped down the surfaces after a couple minutes.
On 12/8/20 at 1:08 PM, Staff 1 was interviewed about training received for use of hdqC2. Staff 1 stated she sprayed hdqC2 on high touched surfaces and immediately dried those surfaces with a cloth.
On 12/8/20 at 1:46 PM, Staff 1 was observed disinfecting a staff bathroom in the COVID positive section of the facility using hdqC2. Staff 1 sprayed the product onto the sink and paper towel dispenser, then immediately wiped those surfaces dry with a cloth.
On 12/8/20 at 2:02 PM, Staff 1 was observed to sanitize vending machines. Staff 1 sprayed hdqC2 onto vending machines, left the surfaces wet for 30 seconds, then dried those surfaces with a cloth.
On 12/8/20 at 3:08 PM, Staff 3 (Interim Administrator) and Staff 4 (DNS) stated an understanding of the need for a 10-minute contact time with hdqC2 and SANI T-10 Plus in order to effectively disinfect surfaces. Staff 3 confirmed all housekeeping and kitchen staff should know how to properly use disinfecting products when sanitizing high touch surfaces in the facility.
F8801. No individual residents were identified in this citation. 2. All staff were re-educated regarding high touch cleaning, disinfection products and dwell (wet) time with a focus on the housekeeping and dietary staff. Facility posted disinfectant posters with dwell time for each brand, and included a Spanish version for Spanish speaking staff. Facility is now using a disinfectant with a shorter dwell time to improve compliance.3. To ensure on-going compliance, the administrator/ designee will complete disinfection audits for proper dwell time via observation and staff interview. 4. These audits will be daily for two weeks, then weekly for four weeks, and will occur monthly until substantial compliance is maintained. Audit outcomes will be reported to monthly quality assurance meeting. Administrator is responsible for compliance. 5. Date of compliance is 1/4/2021
A COVID-19 Infection Control Survey and a COVID-19 Confirmed Facility Review were conducted by the Oregon State Survey Agency 12/8/20 to 12/10/20.
Total residents: 26
A deficiency was cited.
Abbreviations possibly used in this document:
ADL: activities of daily living
bid: twice a day
BIMS: Brief Interview for Mental Status
CAA: Care Area Assessment
CBG: capillary blood glucose or blood sugar
cm: centimeter
CMA: Certified Medication Aide
CNA: Certified Nursing Assistant
CPR: Cardiopulmonary Resuscitation
DNS: Director of Nursing Services
F: Fahrenheit
FRI: Facility Reported Incident
HS or hs: hour of sleep
LPN: Licensed Practical Nurse
MAR: Medication Administration Record
mcg: microgram
MDS: Minimum Data Set
mg: milligram
ml: milliliters
O2 sats: oxygen saturation in the blood
OT: Occupational Therapist
PCP: Primary Care Physician
PO: by mouth, orally
PRN: as needed
PT: Physical Therapist
RA: Restorative Aide
RAI: Resident Assessment Instrument
RD: Registered Dietitian
ROM: range of motion
RN: Registered Nurse
RNCM: Registered Nurse Care Manager
SA: State Agency
SLP: Speech Language Pathologist
TAR: Treatment Administration Record
tid: three times a day
UA: Urinary Analysis
UTI: Urinary Tract Infection
A COVID-19 Focused Infection Control Revisit Survey was conducted by the Oregon State Survey Agency on 1/29/21.
The facility was found to be in complaince.
Total Residents: 35
A COVID-19 Infection Control Survey and a COVID-19 Confirmed Facility Review were conducted by the Oregon State Survey Agency on 12/8/20 to 12/10/20.
Total residents: 26
A deficiency was cited.
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OAR 411-086-0330 Infection Control and Universal Precautions
Refer to F880
