Bringing transparency to federal inspections
Tag No.: C1206
Based on document review and interview it was revealed the facility failed to ensure the guidelines for quarantine and return to work for COVID-19 were followed for four (4) of forty-eight (48) employees who were listed on a spreadsheet as having had exposure to COVID-19, symptoms or testing from 11/1/20 to 1/18/21 (Employees #9, 18, 19 and 33). The failure to follow the guidelines has the potential to adversely affect all employees, patients and visitors.
Findings include:
1. A review of the hospital policy entitled 'COVID-19,' last revision date 9/22/20, revealed in part: "Persons infected with COVID-19 have a wide range of symptoms reported-ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus."
2. A review of the Center for Disease Control (CDC) article entitled 'Options to Reduce Quarantine for Contacts of Persons with SARS-Cov-2 Infection Using Symptom Monitoring and Diagnostic Testing,' updated 12/2/20, revealed in part: "Local public health authorities determine and establish the quarantine options for their jurisdictions ...the following options to shorten quarantine are acceptable alternatives. Quarantine can end after day 10 with no testing and if no symptoms have been reported during daily monitoring ...When diagnostic testing resources are sufficient and available, then quarantine can end after Day 7 if a diagnostic specimen tests negative and if no symptoms were reported during daily monitoring. The specimen may be collected and tested within 48 hours before the time of planned quarantine discontinuation (e.g. in anticipation of testing delays), but quarantine cannot be discontinued earlier than after Day 7."
3. A review of the Jackson County Health Department's (local health authority) website revealed the CDC listed as a resource.
4. A review of the facility document entitled 'Criteria for Return to Work for Healthcare Workers Exposed or with Confirmed COVID-19,' updated 12/31/20, revealed in part: "Criteria for HCW Exposed to Confirmed COVID-19 - If HCP for the confirmed/documented COVID-19 person did not wear a mask and was within 3 ft for 15 minutes or longer then they must self-quarantine/self-monitor for 5 days. If the employee remains asymptomatic at the end of 5 days they will return to work, masked ..."
5. A review of the document entitled 'JGH COVID-19 Exposure Screening Tool Asymptomatic Employee,' updated 8/6/20, revealed in part: "Healthcare Professional (HCP) with Potential Exposure in the Healthcare Setting or the Community: Please note the following guidelines assume the HCP has no active symptoms of COVID-19. Did the HCP or the confirmed/documented COVID-19 person wear a mask within 3 ft for 15 minutes or longer? If YES, No work restrictions. If NO, Self-quarantine for 5 days, then return to work ..."
6. A review of the spreadsheet listing employee name, department, symptom onset/exposure date/quarantine start, test date, release/return date revealed employee #9 had a COVID-19 exposure to a family member and was quarantined for seven (7) days from 11/25/20 to 12/1/20. Testing was not documented.
7. A review of the spreadsheet listing employee name, department, symptom onset/exposure date/quarantine start, test date, release/return date revealed employee #18 had a COVID-19 exposure to another staff member and was quarantined for seven (7) days from 12/5/20 to 12/11/20. Testing was not documented.
8. A review of the spreadsheet listing employee name, department, symptom onset/exposure date/quarantine start, test date, release/return date revealed employee #19 had a COVID-19 exposure to another staff member and was quarantined for seven (7) days from 12/5/20 to 12/11/20. Testing was not documented.
9. A review of the spreadsheet listing employee name, department, symptom onset/exposure date/quarantine start, test date, release/return date revealed employee #33 had a COVID-19 exposure to a family member and was quarantined for six (6) days from 12/17/20 to 12/22/20. Testing was not documented.
10. A telephone interview conducted on 1/19/21 at approximately 8:05 a.m. with employee #9 revealed he had called the West Virginia University (WVU) Employee Health hotline and was told to quarantine for seven (7) days. If he did not have any symptoms he could return to work. He did not have a COVID-19 test before returning to work.
11. A telephone interview conducted on 1/19/21 at approximately 10:25 a.m. with employee #18 revealed she had been exposed on 12/5/20, a Saturday, and had worked on Sunday and Monday. She said she received a call from the Chief Nursing Officer (CNO) on Tuesday and was told she had been exposed to another staff member and needed to quarantine for five (5) days. She stated she did not have any symptoms and did not have a test done.
12. A telephone interview conducted on 1/19/21 at approximately 2:30 p.m. with employee #19 revealed she had been exposed on 12/5/20, a Saturday, and found out on Tuesday or Wednesday. She said she received a call from the CNO and was told she had been exposed and should quarantine until Friday. She said she did not have to call the WVU Employee Health hotline unless she had symptoms. She said she did not have a test done.
13. A telephone interview conducted on 1/19/21 at approximately 8:10 a.m. with employee #33 revealed she had called the Employee Health hotline and was told to quarantine for five (5) days. She said she lives in Ohio and had received a test at the Emergency Room in Meigs County. She stated the test was negative. This was not documented on the spreadsheet.
14. A telephone interview conducted with the CNO during the entrance conference on 1/18/21 at approximately 11:30 a.m. revealed the employees call the WVU Employee Health hotline if they have been exposed to COVID-19 or have symptoms. If they have symptoms, they stay out of work for fourteen (14) days. If they do not have any symptoms they can return to work after five (5) days.
15. A telephone interview conducted with the CNO on 1/19/21 at approximately 3:10 p.m. revealed they used the 'Criteria for Return to Work for Healthcare Workers Exposed or with Confirmed COVID-19' policy which is Appendix A to Policy V.112s ('Guidelines for Employees with Novel Coronavirus').