HospitalInspections.org

Based on observation, record review, and interview, the facility failed to implement effective infection control measures for 12 (Staff A, B, C, D, E, G, H, I, K, L, M, and N) of 14 employees identified as medium or high-risk exposure to the novel coronavirus (COVID-19).

The findings included:

A review of an email from Lee County Department of Health, dated 3/30/20 revealed the facility's Chief Nursing Officer (CNO) and Employee Health/Infection Control Nurse were informed a COVID-19 positive patient was in the facility on 3/22/20. Any employee identified as medium or high-risk exposure are to be excluded from work for 14 days after the last known exposure.

A review of the facility "COVID-19 Travel and Exposure Evaluation for Return to Work INTERIM Policy" dated 1/2020 and revised 2/2020 revealed under section 3(a) High and Medium risk Exposure Category "HCP [Health Care Personnel], in the high- or medium-risk category, should undergo active monitoring, including restriction from work in any healthcare setting until 14 days after their last exposure."

A review of the facility "Return to Work Criteria for Employees with Confirmed or Suspected COVID-19" dated 1/2020 and revised 3/2020 revealed under section 3(a) Test-based Strategy revealed employees can return to work after "Negative results of an FDO [sic] Emergency Use Authorized molecular assay for COVID-19 from at least two consecutive nasopharyngeal swab specimens collected at least 24 hours apart."

A review of facility time records revealed the following:

Physician Staff A was identified as a high-risk exposure to COVID-19. Quarantine began on 3/30/20 and ended on 4/13/20. On 4/10/20 at 9:54 a.m., Physician Staff A was observed working on the 3rd floor of the facility. Physician Staff A said, at the time of the observation, she had tested negative on 4/1/20 and returned to work in the facility. There is no evidence of a second COVID-19 test.

Physician Staff B was identified as a medium-risk exposure to COVID-19. Quarantine began on 3/26/20 and ended on 4/9/20. Physician Staff B worked 4/1/20, 4/2/20, 4/3/20, and 4/4/20. Physician Staff B had a single negative COVID-19 test result on 4/1/20. There is no evidence of a second test.

Unit Secretary Staff C was identified as a high-risk exposure to COVID-19. Quarantine began on 3/30/20 and ended on 4/13/20. Time records revealed Unit Secretary Staff C worked 3/31/20, 4/1/20, 4/4/20, 4/5/20, 4/7/20, and 4/8/20. There is no record of a COVID-19 test result for Unit Secretary Staff C.

Registration Clerk Staff D was identified as a medium-risk exposure to COVID-19. Quarantine began 3/30/20 and ended on 4/13/20. Time records revealed Registration Clerk Staff D worked 3/31/20, 4/3/20, 4/4/20, and 4/5/20. There is no record of a COVID-19 test result for Registration Clerk Staff D.

Unit Secretary Staff E was identified as a high-risk exposure to COVID-19. Quarantine began on 3/30/20 and ended on 4/13/20. Time records revealed Unit Secretary Staff E worked 3/31/20, 4/1/20, 4/2/20, 4/5/20, 4/6/20, and 4/7/20. Unit Secretary Staff E had a COVID-19 negative test result on 4/2/20. There is no record of a second test.

Registered Nurse (RN) Staff G was identified as a medium-risk exposure to COVID-19. Quarantine began on 3/30/20 and ended on 4/13/20. Time records revealed RN Staff G worked 4/6/20, 4/8/20, and 4/9/20. RN Staff G had a negative COVID-19 test on 3/31/20. There is no record of a second test.

RN Staff H was identified as a high-risk exposure to COVID-19. Quarantine began on 3/22/20 and ended on 4/5/20. Time records revealed RN Staff H worked 3/31/20, 4/1/20, and 4/2/20. RN Staff H had a negative COVID-19 test result on 3/31/20. There is no record of a second test.

Registration Staff I was identified as a medium-risk exposure to COVID-19. Quarantine began on 3/22/20 and ended on 4/5/20. Time records revealed Registration Staff I worked 4/2/20, 4/3/20, and 4/4/20. Registration Staff I had a negative COVID-19 test result on 3/31/20. There is no record of a second test.

RN Staff K was identified as a medium-risk exposure to COVID-19. Quarantine began on 3/27/20 and ended on 4/10/20. Time records revealed RN Staff K worked 3/30/20, and 3/31/20. RN Staff K had a negative COVID-19 test on 3/31/20. There is no record of a second test.

Computed Tomography (CT) Tech Staff L was identified as a high-risk exposure to COVID-19. Quarantine began 3/30/20 ended on 4/13/20. Time records revealed CT Tech Staff worked 3/31/20, 4/1/20, and 4/4/20. There is no record of a COVID-19 test result for CT Tech Staff L.

RN Staff M was identified as a high-risk exposure to COVID-19. Quarantine began on 3/30/20 and ended on 4/13/20. Time records revealed RN Staff M worked 3/31/20, 4/1/20, 4/3/20, 4/4/20, and 4/5/20. RN Staff M had a COVID-19 test on 4/8/20 with results pending.

Certified Nursing Assistant (CNA) Staff N was identified as an unknown COVID-19 exposure risk. Quarantine began 3/30/20 and ended 4/13/20. CNA Staff N was advised by the Department of Health, in writing, advising CNA Staff N to self-isolate until 4/14/20. Time records revealed CNA Staff N worked 4/3/20 and 4/4/20. CNA Staff N had a negative COVID-19 test on 3/30/20. There is no record of a second test.

On 4/10/20 at 12:49 p.m., the Infection Control nurse, who is also the employee health nurse, confirmed staff determined to be medium or high-risk exposure to COVID-19 must self-quarantine for 14 days. She also confirmed the testing status of the employees who have returned to work. She was unaware Unit Secretary Staff C, Registration Clerk Staff D, or CT Tech Staff L had no COVID-19 test results.

On 4/10/20 at 4:15 p.m., DOH Staff O said employees are to provide the facility with letters to indicate they are safe to return to work. Allowing employees with a single negative COVID-19 test result within the 14-day quarantine period is not consistent with the current DOH guidance.