A recent Iowa state inspection report indicates that a nursing assistant with COVID-19 was allowed to work while she was ill and exhibiting symptoms. The aide called in sick at her job in another facility and was told to stay out for two weeks. Claiming she was symptom free, the aide was able to continue working from April 24 – May 4 because the second facility allowed staff to “self-monitor” instead of having a staff member provide monitoring by taking temperatures and asking questions about symptoms at the beginning of each shift.
Once inside the facility, the Coronavirus spread rapidly, infecting 79 residents and staff members. Residents first started showing symptoms on May 15. Fifteen residents died, and the others who were infected recovered.
Last week, the Iowa Department of Inspections and Appeals issued citations for the facility’s failure to screen incoming staff and proposed a fine of $8,750, which was suspended pending federal regulators’ further consideration.
The report also indicated that the facility was not in “substantial compliance” with federal guidelines for stopping the spread of COVID-19. The facility was also cited for failing to conduct annual performance evaluations of nursing assistants and offering them required in-service training.
Compliance Perspective
Failure to follow the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) guidelines for controlling the spread of COVID-19 by not adequately monitoring incoming staff by taking their temperature and asking appropriate questions places residents in immediate jeopardy for contracting the disease due to their age and underlying medical conditions. This may result in citations and fines, and be considered provision of substandard quality of care, in violation of state and federal regulations.
Discussion Points:
- Review policies and procedures to ensure that CMS and CDC guidelines for preventing the spread of COVID-19 are in place and being followed.
- Train staff regarding those guidelines, with specific emphasis on not working when ill and exhibiting symptoms for the disease. Also, train staff to report any employee suspected of being ill and exhibiting symptoms of the Coronavirus to their supervisor of through the facility’s Hotline.
- Periodically audit to ensure that persons entering the facility are being carefully screened, and that staff are receiving annual reviews and required in-house training.
