HospitalInspections.org

Based on observation, interview, and document review, the facility failed to follow Minnesota Executive Order 20-51 and Centers for Disease Control (CDC) screening guidelines to actively screen staff upon entering the facility.

Findings include:

The Minnesota Executive Order 20-51 https://www.leg.state.mn.us/archive/execorders/20-51.pdf dated 5/5/20, directed, "Facilities must conduct active health screening of all staff (e.g., providers, medical assistants, support staff, environmental services staff) at the beginning of each shift, patients, and visitors entering the facility, to assess for signs and symptoms of COVID-19. Screening must include assessment for symptoms associated with infection, as recommended in CDC." CDC: Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings updated 5/18/20, https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html directs, "Screen all HCP at the beginning of their shift for fever and symptoms consistent with COVID-19. Actively take their temperature and document absence of symptoms consistent with COVID-19. If they are ill, have them keep their cloth face covering or facemask on and leave the workplace."

On 7/9/20, at 10:21 a.m. licensed practical nurse (LPN)-A stated employees used the shipping and receiving entrance when reporting to work. LPN-A stated upon entering the facility, she was generally screened by another person, but at times she had performed self-screenings as no other staff were at the screening station when she arrived to work.

On 7/9/20, at 10:45 a.m. registered nurse (RN)-B stated employees used the facility shipping and receiving entrance when reporting to work. RN-B stated "most of the time," a staff-person was available at the screening station to screen staff upon arrival to work, but when an additional staff member was not there, she would perform a self-screening. RN-B stated when she performed a self-screening, she needed to report to the nurses' station and have her screening verified.

On 7/9/20, at 10:54 a.m. RN-C stated employees used the facility shipping and receiving entrance when arriving to work. RN-C stated when working the night shift, about three weeks ago, she had performed a self screening and proceeded to the nurses' station and had her screening verified. RN-C stated a log was kept at the nurses' station which indicated when employees had self-screenings verified.

On 7/9/20, at 11:06 a.m. the shipping and receiving entrance was observed with RN-D. The area was unmanned and a bedside table was noted to have a thermometer and log book on top of it. A sign was posted which read "Change Effective 6/3/20 If there is no screener here. Please self-screen and report to the Acute Care or LTC [long-term care] to be rescreened." RN-D stated a screener was assigned during day shift however, nightshift employees performed self-screenings. RN-D stated employees who performed self-screenings were to report to the nurses' station to have their screening verified and there was a log at the nurses' station which indicated which employees had self-screenings verified by another staff-person.

On 7/9/20, at 11:49 a.m. RN-D stated there was no log at the nurses' station which indicated which employees had self-screenings verified by another staff-person. RN-D stated employees who had self-screening verifications completed, were documented on the facility visitor screening log.

On 7/9/20, at 1:08 p.m. RN-D stated a gap in documentation was identified and verified employees had not been consistently documenting when self-screenings were verified at the nurses' station.

The facility policy titled Screening Guidelines for Suspected Covid-19 Viral disease dated 6/13/20, directed "All patients and employees presenting to the hospital or the clinics shall be asked questions and temperature screened prior to entry for the purpose of screening."