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Based on medical record review, facility policy, and staff interview, it was determined the facility failed to follow their policy on reportable disease requirements of the local health authority. This failure had the potential to allow communicable disease to spread in the community.

A facility policy titled "Reportable Diseases - Idaho" dated 1/23/17, listed Cryptosporidiosis as a group 3 parasitic disease, which indicated that it must be reported to the local health district within 3 working days of case identification. The policy also included a section with the procedure of reporting communicable diseases. It stated, "The Infection Prevention (IP) Department will report the disease to the appropriate health district." This policy was not followed.

Patient #1 was a 61 year old female seen at the Emergency Department on 9/27/17 for nausea, vomiting, and diarrhea. She was discharged home on 9/27/17. Her emergency room record was reviewed.

Patient #1's record included an emergency room progress note dated 9/29/17, signed by a Registered Nurse (RN). The note documented the microbiology laboratory called the emergency department and reported a positive result for Cryptosporidium, the parasite that cause Cryptosporidiosis. It was also documented in the progress note the RN spoke with the physician working in the emergency department at the time, regarding the result. It also stated that she spoke with the patient about how she was feeling, and that the emergency department would call with any change to her treatment plan.

The Laboratory Supervisor was interviewed on 2/20/18, at 1:30 PM. She stated the process for reporting communicable diseases is the laboratory would fax the positive result to the IP department. After the IP department received the positive laboratory result, it would report it to the local health district when necessary. The Lab Supervisor stated it was documented that the positive result for Patient #1 was faxed to the IP department on 9/28/17 at 9:38 PM.

The Director of Patient Safety was interviewed on 2/21/18, at 2:05 PM. She confirmed the IP department had no record of a fax received from the laboratory department for Patient #1's positive Cryptosporidium result. She also confirmed there was no documentation the positive Cryptosporidium result was reported to local health authority.

The facility failed to ensure all reportable communicable diseases were reported to the appropriate local health authority.