Health inspection·October 26, 2023

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to implement their Infection prevention and control policy and procedures (P&P) by failing to: Residents Affected - Some a. Ensure staff doffed (removed) personal protective equipment ([PPE] specialized clothing or equipment such as a gown, respirator and face shield worn to minimize exposure to serious illness) prior to exiting a Coronavirus Disease ([Covid 19] a highly contagious respiratory infection caused by a virus that could easily spread from person to person) isolation room (designated room to separate sick resident with a contagious illness). b. Ensure nurses maintained short and well-trimmed fingernails. c. Report the facility's Covid-19 outbreak (at least one confirmed case of Covid-19 who had resided in the facility for at least 7 days) to the California Department of Public Health (CDPH) District Office. These deficient practices had the potential to result in the spread of covid-19 and infections to residents, staff and visitors. Findings: a. During a concurrent observation and interview on 10/25/2023 at 12:45 p.m. with Certified Nurse Assistant (CNA) 1, CNA 1 was observed exiting a covid-19 isolation room into the hallway with a yellow isolation gown on. CNA 1 stated she was removing a lunch tray from the room and made a mistake of not removing her PPE. CNA 1 also stated wearing the gown into the hallway could spread infection to others. b.During a concurrent observation and interview on 10/25/2023 at 3:20 p.m. with CNA 2, CNA 2 was observed with long fingernails (approximately greater than ¼ inch beyond the fingertips). During a concurrent observation on 10/25/2023 at 4 p.m. with Registered Nurse (RN) 1, RN 1 was observed with long fingernails. RN 1 stated having long fingernails could contribute to the spread of Page 1 of 3 555130 555130 10/26/2023 Maywood Skilled Nursing & Wellness Centre 6025 Pine Ave Maywood, CA 90270

F 0880 infection. Level of Harm - Minimal harm or potential for actual harm During an interview on 10/26/2023 at 10 a.m. with the infection preventionist (IP), IP stated staff should not have long fingernails in the resident's care area because long fingernails could harbor dirt and bacteria which could contribute to the transmission of infection to the residents. Residents Affected - Some c.During a review of Resident 6's admission Record (Face Sheet), the Face Sheet indicated Resident 6 was initially admitted on [DATE] and readmitted on [DATE] with diagnoses including covid-19, chronic obstructive pulmonary disease ([COPD] lung disease that block airflow and made it difficult to breathe) and diabetes (high blood sugar). During a review of Resident 6's Minimum Data Set ([MDS], a standardized assessment and care planning tool) dated 8/21/2023, the MDS indicated Resident 6 had severely impaired cognition (ability to think and reason). The MDS also indicated Resident 6 required limited (resident involved in activity, staff provide weight-bearing support) to extensive (resident involved in activity, staff provide weight-bearing support) assistance for Activities of Daily Living (ADL's) including bed mobility, transfer, walking, dressing, eating, toilet use and personal hygiene. During a review of Resident 6's Lab Results Report dated 10/22/2023, the Report indicated Resident 6 tested positive for covid-19. During an interview on 10/26/2023 at 10 a.m. with IP, IP stated there were 18 residents positive for Covid-19 in the facility. During an interview on 10/26/2023 at 11 a.m. with the Administrator (ADM), the ADM stated that the facility COVID-19 outbreak was not reported to state licensing district office because he was not aware that it needed to be reported. During a review of the facility's P&P titled, Infection Control 1/1/2012, the P&P indicated the facility would maintain a safe, sanitary, and comfortable environment and help prevent and manage transmission of diseases and infections. During a review of the facility's P&P titled, Personal Protective Equipment Infection Control Manual dated 1/1/2012, the PPE indicated, when gowns were used, they were used only once and discarded into appropriate receptacles located in the room. During a review of the facility's undated P&P titled, Standard Operating Procedure: COVID-19 Enhanced Droplet & Contact Precautions, the P&P indicated doffing procedure as follows: ensure all doffing materials were available and in place (i.e. hand sanitizer, waste supplies), doff gloves, doff gown by gently removing gown forward and placing into appropriate container, sanitize hands, doff face shield, sanitize hands and exit resident's room. During a review of the facility's P&P titled, Covid 19 (coronavirus disease 2019) Infection Control Manual dated 9/16/2020, the P&P indicated the purpose was to identify and report immediately to the required agencies any case of diagnosed Covid-19 or Person Under Investigation (PUI) for Covid-19 infection. The P&P also indicated to immediately report any residents or staff members suspected of or diagnosed with covid-19 to the local health department (LHD) and the CDPH. During a review of Centers for Disease Control and Prevention (CDC) guidelines titled, Hand hygiene 555130 Page 2 of 3 555130 10/26/2023 Maywood Skilled Nursing & Wellness Centre 6025 Pine Ave Maywood, CA 90270

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some in Healthcare Settings, dated 1/8/2021, the guidelines indicated healthcare workers should keep natural nail tips less than 1/4 inch long. During a review of the CDC's Recommendation titled Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the (COVID-19) Pandemic, dated 5/8/2023, the recommendation indicated healthcare facilities responding to COVID-19 transmission within the facility should always notify and follow the recommendations of public health authorities. 555130 Page 3 of 3