HospitalInspections.org

Based on observation and interview, on three of four surveyor entries to the hospital lobby and during the emergency department (ED) tour, the hospital failed to implement public health recommendations to screen arriving persons for symptoms in order to contain COVID-19. The deficient practice increased the risk of transmitting COVID-19 at the hospital.

Findings:

In an observation on 12/9/20 at approximately 10:30 a.m., no symptom screening was being conducted at the main entrance to the hospital lobby; the surveyor was able to enter through the main hospital lobby and join the queue at the registration desk without being asked regarding COVID-19 symptoms.

In an observation and interview on 12/9/20 at approximately 10:45 a.m., the ED entrance to the hospital had a vacant podium in the doorway. An adult male holding a male child by the hand and an elderly male entered the hospital through the ED entrance and were not asked regarding COVID-19 symptoms. The Director of Acute Care Services stated the hospital did not have someone who screens every person as they walk through the door. The Admitting Clerk stated the registration desk was shared between the ED and other outpatient departments, and patients were asked there for identification, their insurance card, whether they've been seen at the hospital before, and whether they have a cough. The Director of Acute Care Services stated if someone was suspected of having COVID, that person wouldn't remain in the ED waiting room long because the admitting clerk would notify the triage nurse.

In an observation and interview on 12/9/20 at approximately 12:30 p.m., the surveyor entered the hospital through the main entrance to the lobby. An unidentified hospital staff was sitting next to a podium at the entrance; the staff indicated he recognized the surveyor was returning by stating, "Welcome back." The staff member did not ask the surveyor whether the surveyor was experiencing COVID symptoms.

In an observation and interview on 12/11/20 at approximately 9:05 a.m., the surveyor entered the hospital through the main entrance to the hospital lobby. An unidentified hospital staff stopped the surveyor, took the surveyor's temperature, and asked the surveyor to complete an electronic symptom questionnaire. The Compliance Officer stated, "We have been doing that for a while."

In an observation on 12/11/20 at approximately 12:00 noon, the surveyor entered the hospital through the main entrance to the hospital lobby. No staff member was present in the hospital entrance.

Review of CMS memo QSO-20-13-Hospitals-CAHs (REVISED) dated 3/30/20, "Guidance for Infection Control and Prevention of Coronavirus Disease (COVID-19) in Hospitals, Psychiatric Hospitals, and Critical Access Hospitals (CAHs): FAQs, Considerations for Patient Triage, Placement, Limits to Visitation, and Availability of 1135 waivers" indicated, "Hospitals, psychiatric hospitals, and CAHs should identify visitors and patients at risk for having COVID-19 infection before or immediately upon arrival to the healthcare facility... For patients [at risk for having COVID-19 infection], implement respiratory hygiene and cough etiquette (i.e., placing a facemask over the patient's nose and mouth if that has not already been done) and isolate the patient in an examination room with the door closed. If the patient cannot be immediately moved to an examination room, ensure they are not allowed to wait among other patients seeking care."