Health inspection·June 27, 2023

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview and record review, the facility failed to implement infection control measures by failing to: Residents Affected - Some 1. Ensure Certified Nurse Assistant (CNA) 2 washed and /or sanitized (make clean and hygienic; disinfect) hands before and after entering the residents ' room to provide care. 2. Ensure CNA 3 washed and/or sanitize hands after disposal of soiled linens before touching clean linen storage to get supplies for the resident. These failures had the potential to result in compromised infection control measures to prevent the potential spread of Covid-19 and other infectious disease among residents, staff, and visitors. Findings: During an observation on 6/27/2023, at 1:40 p.m., in a hallway near room A (RM A), CNA 2 entered room A to get the lunch tray, without washing hands. Upon exiting RM A with the tray, CNA 2 did not wash his hands and pushed the tray cart to another hallway. During an observation on 6/27/2023, at 1:45 p.m., in a hallway near room B (RM B), CNA 2 entered RM B to answer the call light without washing his hands and covered the resident with blanket as requested by the resident. CNA 2 did not wash his hands when he exited the room. During an observation on 6/27/2023, at 1:48 p.m., in a hallway near room C (RM C), CNA 2 entered RM C to answer the call light without washing his hands and handed a cup of water to the resident. CNA 2 did not wash his hands after exiting the room. During an observation on 6/27/2023, at 1:50 p.m., in a hallway near room D (RM D), CNA 2 entered RM D to assist CNA 3 to reposition the resident without washing his hands upon entering the room. During an interview on 6/27/2023, at 1:55 p.m., in a hallway near RM D, with CNA 2, CNA 2 stated, he did not wash his hands before and after entering residents ' room to provide care to the residents in RMs A, B, C, and D. CNA 2 stated, it was important to maintain hand hygiene to protect residents from getting infectious disease and he should have washed his hands before and after providing care to the residents. CNA 2 stated, he was focusing on answering the call lights and did not realize he was cross- contaminating (the transfer of harmful bacteria from one person, object, or place to another) among the residents by not washing his hands before and after entering the rooms. During an observation on 6/27/2023, at 2:05 p.m., in a hallway near RM D, CNA 3 came out from RM D Page 1 of 2 055744 055744 06/27/2023 Atlantic Memorial Healthcare Center 2750 Atlantic Avenue Long Beach, CA 90806

F 0880 Level of Harm - Minimal harm or potential for actual harm with soiled linen in plastic bags and held the plastic bags with soiled linen in them without wearing gloves. CNA 3 lifted hamper top up and discarded the soiled linen. CNA 3 did not wash or sanitize her hands and touched the door knob of the clean linen storage room. CNA 3 opened and entered the clean linen storage room to get clean linen and an adult brief. CNA 3 entered RM D without washing hands to apply clean linen and the adult brief to the resident. Residents Affected - Some During an interview on 6/27/2023, at 2:08 p.m., in a hallway near RM D, with CNA 3, CNA 3 stated, she should have brought the hamper close to RM D to discard the bags of dirty linen. CNA 3 stated, she did not want to walk out of RM D with soiled linen, but she forgot to bring the hamper near room D. CNA 3 stated, she should have washed her hands after discarding soiled linen in the hamper before entering the clean linen storage room. CNA 3 stated, practicing hand hygiene was important to prevent spreading infections to the residents and staff. During an interview on 6/27/2023, at 3:50 p.m., with Infection Preventionist (IP), IP stated, good hand hygiene practice was the best way to prevent the spread of infectious disease such as covid 19 and Clostridiodies difficile ([C-diff]-a germ that causes diarrhea and inflammation of the colon) infection. IP stated that hand hygiene was important, and she provided education to staff frequently. IP stated, CNAs should wash their hands before entering the room because they might have to provide direct care to the residents thereby touching the residents ' body when providing assistance. IP stated, CNAs should wash their hands after they are done providing care to prevent possible cross-contamination. IP stated, clean the hands with alcohol-based hand sanitizer if not visibly soiled. IP stated, clean the hands with soap and water when they were visibly soiled. During an interview on 6/28/2023, at 1:33 p.m., with the Director of Nursing (DON), DON stated, all staff should follow the hand hygiene policy and procedure. DON stated, keeping good hand hygiene would prevent spreading infectious disease and it was the first defense line to prevent infection to protect the residents and staff. During a review of the facility ' s policy and procedure (P&P) titled, Hand Hygiene, revised 10/2022, the P&P indicated, Purpose: Hand hygiene is one of the most effective measures to prevent the spread of infection. Studies show that effective hand decontamination can significantly reduce the rate of healthcare associated infection. All personnel shall follow the handwashing/hand hygiene procedure to help prevent the spread of infections to other personnel, residents, and visitors. Procedure:2. Use an alcohol-based hand rub containing at least 62% alcohol; or, alternatively, soap and water for the following situations: b.Before and after direct contact with residents .h. Before moving from a contaminated body site to a clean body site during resident care; i. After contact with a resident's intact skin; j.After contact with blood or bodily fluids; k. After handling used dressings, contaminated equipment, etc.; m. After removing gloves; .o. Before and after eating or handling food . and q. After personal use of the toilet or conducting your personal hygiene. During a review of the facility ' s policy and procedure (P&P) titled, Infection Control and Prevention Policy, revised 6/8/2021, the P&P indicated, Policy: It is the policy of this facility to include preparatory plans and actions to respond to the threat of the Covid-19, including but not limited to infection prevention and control practices in order to prevent transmission. Procedure .2. Adhere to Standard and Transmission-Based Precautions .Hand Hygiene- Healthcare personnel should perform hand hygiene before and after all patient contact, contact with potentially infectious material, and before putting on and after removing PPE, including gloves. Hand hygiene after removing PPE is particularly important to remove any pathogens that might have been transferred to bare hands during the removal process. 055744 Page 2 of 2