HospitalInspections.org

Based on interview and document review, the facility failed to follow Centers for Medicare and Medicaid Services (CMS) and Centers for Disease Control (CDC) guidelines for COVID-19 by not appropriately screening staff for symptoms upon entrance to 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, directs, "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."

Review of the facility infection control (IC) policies for COVID-19, did not include a written policy for employee screening. Although there was not a written policy, the staff were given direction through an e-mail dated 4/15/20, on COVID-19 employee screening. The e-mail directed all facility employees to report to the nurses station during off hours for screening. The staff are to enter the employee entrance after business hours. These off hour times are Monday-Friday from 5::00 p.m. to 6:00 a.m. and all day on the weekend. There is no active screener at the employee entrance.

Interview on 6/9/20, at 10:30 a.m., registered nurse (RN)-A indicated staff that enter the facility employee entrance door during off business hours, are not screened at the door. RN-A further included all staff walk through a patient hallway and past several patient rooms to get to the nurses station, before being screened.

Interview on 6/9/20, at 10:45 a.m. RN-B indicated all staff that enter the facility during off business hours are not screened at the facility entrance door. RN-B further included staff walk through a patient hallway and past several patient rooms, before being screened at the nurses station.

Interview on 6/9/20, at 11:00 a.m. the facility housekeeping supervisor (HS) indicated all staff enter the employee entrance door during off business hours. The HS further indicated there was not an active screener at the employee entrance door during these times. HS confirmed staff walk through a patient hallway and past several patient rooms before being screened, at the nurses station

Interview on 6/9/20, at 1:00 p.m. with the director of nursing (DON) and the infection preventionist (IP) confirmed the above screening process during off business hours. The DON and IP both verified all staff working during these times were not screened for COVID-19, upon entering the facility. The DON further verified staff walk by several patient rooms to get to the nurses station, to be screened.