Palm Garden of Pinellas Fails to Comply with Infection Prevention Requirements
After a COVID-19 visit for Palm Garden of Pinellas, the nursing home facility was cited for failing to comply with infection prevention and control requirements. This facility was also discussed in a past blog post, which you can read here.
Based on observation, interview, policy and procedure, standard precautions, and the Centers for Disease Control and Prevention, the facility did not ensure the following:
- Hygiene was utilized after disposing garbage;
- Personal protective equipment was worn appropriately;
- Best practices for nail length were followed by a Unit Manager;
- Residents’ personal linen was distributed in a clean and sanitary manner.
This resulted in the increased chance for contaminates to spread across the facility.
During the observation, the investigator noted a housekeeper exiting the hair salon carrying a large bag of garbage. According to the citation, the housekeeper walked across the hallway, transferred the garbage to her other hand, and stopped outside a door that said “dirty utility room.” The housekeeper then entered the code on the keypad and entered the room. After tossing the garbage into a bin, she walked across the hallway back to the salon. The surveyor asked the housekeeper if she was going to perform hand hygiene after disposing of the garbage. She said yes as she walked away.
That same day, the investigator observed a lunch cart that appeared in the East hallway. Numerous staff members began to congregate in the area. According to the investigator’s notes, a certified nursing assistant (CNA) was wearing an N95 mask. An N95 mask is worn to prevent medical personnel from inhaling and spreading airborne particles. As the investigator observed the CNA, she began readjusting the mask “over 5 times.” The CNA said the mask was her own and that she wears it at the facility; other staff were wearing surgical masks. The CNA was asked if anyone had educated her on how to wear the N95 mask. She replied, “no.”
The investigator then reviewed the “Interim Additional Guidance for… Prevention and Control for Patients Suspected or Confirmed COVID-19 in Nursing Homes.” The procedures indicate the following: “Extreme care must be taken to avoid touching the face mask. If this must occur, HCP (health care professionals) should perform hygiene immediately before and after contact to prevent contaminating themselves or others.” The citation did not indicate whether or not the CNA performed proper hygiene after readjusting the mask multiple times and continuing about her day.
During the distribution of lunch trays, the investigator observed a staff member filling cups of coffee for others. The investigator noticed the staff member was wearing acrylic nails that were “over two inches in length.” At the time, the staff member was a Unit Manager. When the investigator spoke to her about the nails, she confirmed they were acrylic and two inches long. She asked the surveyor, “should I wear gloves?”
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In response to this observation, the investigator obtained a copy of the nursing home facility’s Team Member Handbook titled “Team Member Expectation.” In regards to personal appearance, the handbook stated the following:
NO acrylic nails are permitted for direct caregivers… The effectiveness… of hygiene can be reduced by the type and length of nails. Individuals wearing nails have been shown to harbor more… organisms, especially gram-negative bacilli and yeasts. Maintaining short nails decreases the risk of puncturing gloves… Studies have demonstrated that both nails and nail extenders contribute to contamination.
The final incident in this citation occurred when the investigator noted a linen cart was uncovered in the hallway. According to the citation, the opening of the linen cart revealed it was “full of residents’ personal clothing.” A laundry worker walked out of a resident’s bedroom shortly after the investigator spotted the linen cart. She removed the clean clothing and went back into the resident’s room, leaving the cart “open and exposed.” She put that resident’s clothing inside the closet and grabbed some empty hangers to take with her. While speaking with the resident, the laundry worker dropped the empty hangers on the floor. She proceeded to pick them up off the floor and then toss them into the linen cart with the clean clothing.
The Nursing Home Administrator was in the hallway at this time, and the investigator asked what the proper procedure is for distributing clean clothing. She confirmed that if something is picked up off the floor, it should not be placed inside of a clean linen cart. The cart should also be covered when sitting in the hallway in order to “prevent contamination during transport.”
Proper sanitary measures in nursing home facilities should always be taken, but they are especially critical during national health pandemics. According to Long Term Care Facility requirements, nursing homes must “establish and maintain a prevention and control program designed to provide a safe, sanitary and comfortable environment to help prevent the development and transmission of communicable” diseases. Even one small error could put residents at risk for disease. It is imperative nursing home facilities follow proper sanitary protocols to protect themselves and those around them.
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