HospitalInspections.org

Based on observation, interview, and document review, the facility failed to follow Minnesota Executive Order 20-51 and Centers for Disease Control (CDC) screening guidelines to actively screen staff upon entering the facility. This had the potential to impact all patients, visitors, and staff at 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."

During the Entrance Conference on 5/21/20, at 9:00 a.m. the administrator identified staff were self-screening and the screening process was not documented.

Interview on 5/21/20 at 9:15 a.m., with the nurse manager (NM)-A identified there were 4 access doors into the facility. Two entrance doors used as employee entrances and the other two doors are for patients and visitors. The employee entrances do not have screening capabilities and the patient/visitor doors have staff to complete verbal and temperature screening.

During observation on 5/21/20, at 9:14 a.m. of the facility Receiving Entrance, which also serves as an employee entrance, is noted to not have a staff person to complete screening of employees or a thermometer at the door entrance.

During an interview on 5/21/20, at 9:16 a.m. the maintenance director stated, "We take our own temperature when we arrive for our shift and again at the end of the shift. Staff document the temperature result on the Employee Temperature Schedule form. There isn't any directive of what to do with the temperature sheet and we don't send the completed sheet to anyone."

During observation of Employee Entrance #2 on 5/21/20, at 9:20 a.m., identified there was no staff person screening employees or thermometer supplied to actively screen staff at the door entrance.

During an observation and interview on 5/21/20, at 9:37 a.m. with registered nurse (RN)-A identified staff complete their own screening.

During an interview on 5/21/20, at 9:45 a.m. RN-B stated, staff take their own temperature at home to verify if they have a fever and if they should go to work. If they have a fever or do not feel good, they are instructed to call the facility for clearance to go to work. Once arriving at work the staff sanitize their hands and proceed to the nurse station to punch in on the computer and take their own temperature. Staff document their temperature on their own a log sheet.

The facility's Enhanced Screening Requirements for Staff Reporting Onsite Procedure dated 5/12/20, identified staff were required to take their temperature twice daily if reporting to work. This was an expectation and responsibility of employment. "Take your temperature right before you leave for work. In adults, a fever is a temperature of 100.5 degrees or greater."