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410 PILGRIM BLVD

HARTFORD CITY, IN 47348

LEADERSHIP RESPONSIBILITIES

Tag No.: C1231

Based on document review, interview and observation, the facility failed to provide a complete COVID-19 screening to everyone who entered the facility per CDC (Centers for Disease Control) guidelines.

Findings Include:

1. Review of policy titled: Indiana University Health Blackford Infection Prevention Plan, 2020 indicated "...based on the Center for Disease Control and Prevention (CDC), Healthcare Infection Control Practices Advisory Committee (HICPAC) guidelines and standards".

2. Interview on 10/29/20 at 9:38 am with P52 (Screener) confirmed that the facility only asks symptom questions to visitors, not patients..."we have never taken temperatures".

3. Interview on 10/29/20 at 10:55 am with P50 (RN, Quality and Risk) confirmed that patients receive symptom questions at registration; do not get temperature taken; no documentation of such.

4. Interview on 10/29/20 at approximately 11:58 am with P54 (Registration Clerk) confirmed that symptom questions are asked when patient registers for service; no temperature taken.

5. Interview on 10/29/20 at 1:00 pm with P50, confirmed that staff self report symptoms through facility's intranet; lacked documentation of daily temperature or symptom questions.

6. Upon entry into facility on 10/29/20 at 9:38 am, this surveyor was given a new mask and asked COVID-19 symptomatic questions. Temperature was not taken and information was not documented.