HospitalInspections.org

Based on observation, staff interview, and review of facility documents, it was determined that the facility failed to ensure all visitors and healthcare personnel entering the facility are provided a screening to identify and isolate Coronavirus Disease 2019 (COVID-19) in accordance with Centers for Disease Control (CDC) guidelines and facility policy.

Findings include:

Reference #1: CDC Interim Infection Prevention and Control Recommendations for Healthcare Personnel [HCP] During the Coronavirus Disease 2019 (COVID-19) Pandemic Infection Control Guidance (updated July 15, 2020) states, " ...Recommended routine infection prevention and control (IPC) practices during the COVID-19 Pandemic ...Screen and Triage Everyone Entering a Healthcare Facility for Signs and Symptoms of COVID-19 ...Screen everyone (patients, HCP, visitors) entering the healthcare facility for symptoms consistent with COVID-19 or exposure to others with SARS-CoV-2 infection and ensure they are practicing source control. Actively take their temperature and document absence of symptoms consistent with COVID-19. ..."

Reference #2: Facility policy titled titled "Visitor Restrictions," Last updated: Friday, October 16, 2020 at 9:15 am "... Hospital visitors will be required to go through both temperature and symptom screening upon entering the facility. ...All visitors arriving from states or countries under a travel advisory that requires a 14-day quarantine upon arrival to New Jersey, will not be permitted to enter an (name) facility. ..."

1. On 10/30/20 at approximately 9:30 AM, this surveyor entered the facility through the main entrance where Staff #17, a security guard, was standing in the carport area of the main entrance. As this surveyor walked past Staff #17, he/she stated, "Good Morning" and allowed this surveyor to enter the main lobby. There was another employee (a women), standing in the main lobby assessing visitors' temperature with a thermal scanner as they entered the facility. She indicated that my temperature was good, and I could proceed to the information desk. I proceeded to the information desk where I was greeted by another women. I identified myself and was told to have a seat in the waiting area, and someone would be with me shortly. I was soon escorted by Staff #1 to the administrative area within the hospital.

a. At no point did either of the three (3) employees I came in contact with screen me for signs and symptoms consistent with COVID-19, exposure to anyone with COVID-19, or travel history to any of the locations outlined in the New Jersey travel advisory, prior to entering the facility.

b. Staff #2, the Manager of Infection Control, confirmed that the screening process is for the security guard outside the entrance to screen all visitors prior to entering the facility. Once the visitor enters the lobby, the thermal scanner assesses their temperature, and they are directed where to go.

c. On 10/30/20 at 1:53 PM, an interview with Staff #16, the Director of Security, was conducted. It was confirmed that Staff #17 had been educated on the visitation policy and the COVID-19 screening process prior to 10/30/20.

d. The facility policy titled "Visitor Restrictions" was requested and reviewed. The facility failed to conduct COVID-19 visitor screening in accordance with the above referenced facility policy and CDC guidelines.

2. On 10/30/20, the visitation log for 10/16/20 for unit 4AB was reviewed. The log indicated that Patient #2, in Room #426, had a visitor at 11:10 AM. The log lacked documentation of absence of symptoms of COVID-19 for visitors.

a. Upon interview, Staff #1 stated that the facility does not keep a screening log documenting absence of COVID-19 symptoms of all visitors entering the facility and was unable to provide documented evidence of screening and absence of symptoms consistent with COVID-19 for the visitor of Patient #2.

b. The facility failed to document absence of symptoms consistent with COVID-19 for visitors entering the healthcare facility in accordance with the above referenced CDC guidelines.

3. On 10/30/20 Staff #2, the Manager of Infection Prevention, confirmed that a cluster of COVID-19 positive cases were identified on the 4AB unit. The first case was identified on 10/16/20 and contact tracing and further COVID-19 testing revealed additional COVID-19 positive cases. Staff #2 stated that the 4AB unit is not a dedicated COVID-19 positive unit. A list of COVID-19 positive patients from the 4AB unit and COVID-19 positive HCP was requested. The list provided included fourteen (14) patients and thirteen (13) HCP.

a. At 11:25 AM, a tour of the 4AB unit was conducted. During an interview, Staff #7 stated that a mobile app (application) on a smartphone is used for employee screening. Each workday the employee is prompted to self-screen using the app. Staff #7 indicated that each employee logs into the app on his/her smartphone and completes a questionnaire (COVID-19 symptom screening) and the app will let the employee know if he/she passed or failed the screening. If an employee fail's the screening, they are not allowed to work and are alerted to contact occupational health for additional screening.

b. Evidence of employee screening (from 10/1/20 thru 10/16/20) for the thirteen (13) employees that tested positive for COVID-19 was requested and not received. Staff #1 confirmed that the facility is unable to go back and view previous employee screenings.

c. The facility failed to provided documented evidence of absence of symptoms consistent with COVID-19 for the thirteen (13) employees, in accordance with the above referenced CDC guideline.