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Based on medical record review, observation and staff interview it was determined the facility failed to ensure a registered nurse supervised and evaluated the nursing care for one (#9) of eleven patients sampled.

Findings include:

Observation of the campus of Centerstone of Florida located at 2020 26th Avenue East, Bradenton, Florida revealed three residential programs housed in the main building:
a. Centerstone of Florida: License number 3977, Hospital-30 beds
b. Manatee Glens Crisis Center: License number 1467, Crisis Stabilization Unit-24 beds
c. Manatee Glens Addiction Center: License number 12-41-AD-9537-04 Residential Level II-7 adult beds, Residential Detoxification-7 adult beds.

Patient #9 was admitted for inpatient psychiatric services to the hospital unit on 8/20/2015 at 4:18 p.m. Review of the patient census dated 8/24/2015, the first day of survey, revealed the patient was listed on the hospital census and documented as "housed on the CSU (Crisis Stabilization Unit)".

Tour of the hospital unit on 8/24/2015 at approximately 1:45 p.m. accompanied by the ADON (Assistant Director of Nursing) and the Risk Manager revealed the hospital unit had a census of 27 patients plus 1. Interview with the case manager and the ADON at the time of the tour confirmed the plus 1 patient was patient #9. Observation of the unit revealed patient #9 was not physically present on the unit.

Interview with the ADON at approximately 2:05 p.m. revealed patient #9 could not be contained on the hospital unit due to the patient wandering into other patients rooms. It was decided the patient should be moved to the CSU for closer monitoring.

Review of the medical record for patient #9 revealed no evidence the physician provided an order to transfer the patient. Review of the medical record revealed no evidence the hospital RN (Registered Nurse) supervised or evaluated the nursing care of patient #9 since admission on 8/20/2015. The ADON confirmed the above findings.

Based on observation, staff interview and review of policy and procedures it was determined the facility failed to ensure the infection control officer developed a system for monitoring staff compliance with policies and procedures for cleaning of non-critical equipment.

Findings include:

1. During tour of the hospital unit on 8/26/2015 at approximately 2:20 p.m. a RN (Registered Nurse) was asked to demonstrate the use of the glucometer. The RN retrieved the glucometer from the nursing station and demonstrated use of the glucometer. The glucometer was stored in a small plastic basket with the supplies needed to obtain a patient's blood glucose. Following observation of the RN's demonstration, the RN was asked to verbalize the cleaning procedure of the glucometer. The RN stated he does not clean it between uses.

Review of the facility policy, "Glucose Monitoring with TRUEbalance Meter", #1204, dated 11/2014, stated (2) the meter should be wiped clean with an alcohol pad before and after each use.

2. During tour of the hospital unit on 8/26/2015 at approximately 2:25 p.m. three observations were made of two technicians completing vital signs on patients. The automatic blood pressure machine was located on a portable cart with wheels in order to move from room to room. In patient room #3 the patient's blood pressure was measured, the cuff removed from the patient and placed in the cart. The technicians then moved to room #5. Upon arrival the technician removed the blood pressure cuff from the cart, put hand sanitizer on part of the cuff and then proceeded to place the cuff on the patient's arm. Following measurement of the patient's blood pressure the cuff was returned to the cart and moved to the next patient located in room #6. The technician proceeded to put hand sanitizer on the blood pressure cuff and then placed the cuff on the patient.

Review of the facility's infection control program, section 5, "Standard/Universal Precautions", stated reusable equipment is not used for the care of another patient until it has been appropriately cleaned".

Interview with the infection control officer on 8/26/2015 at approximately 3:15 p.m. confirmed staff are monitored periodically for compliance with infection control standards. She confirmed the above findings and confirmed the staff's failure to follow facility policy and procedures.