Health inspection·March 15, 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 maintain an infection control program designed to prevent the development and transmission of infection for two of six residents (Resident #35 and #210) observed for infection control. Residents Affected - Few CNA A failed to perform hand hygiene during while providing incontinence care to Resident # 35. CNA B failed to perform hand hygiene during while providing incontinence care to Resident # 210. This failure could placed the residents at risk for infection. Findings include: Record review of Resident #35's face sheet dated 3/15/23 reflected he was [AGE] years old male. He was admitted to the facility on [DATE]. He was admitted with fracture of tibia (larger of the two bones in the lower leg), respiratory failure, heart failure, difficult walking and need for assistance with personal care. Review of Resident #35's care plan initiated 2/13/23 reflected the resident had an ADL self-care performance deficit related to Orthopedic surgery and the intervention was for the resident to be assisted by staff for toileting. Observation on 03/13/23 at 10:40 AM revealed CNA A providing incontinent care for Resident #35. CNA A was in Resident #45's room when she left and stated she was going to get wipes. When CNA A came back in the room, she gloved without performing hand hygiene and proceeded to providing the resident with care. CNA A cleaned the resident and removed the dirty brief, the resident was soiled in urine. CNA A then placed the dirty brief in the trash can and cleaned the resident's bottom. After cleaning the resident without any form of hand hygiene or change of gloves, CNA A applied the clean brief, fastened the brief, and assisted the resident to position in bed. After care, CNA A completed hand hygiene. In an interview on 03/13/23 1at 2:02 PM with CNA A regarding the Resident #35's care, CNA A stated she was supposed to complete hand hygiene before and after care. Asked about in between care, CNA A stated after cleaning the resident she was supposed to clean her hands and change gloves before applying the clean brief. CNA A stated she was supposed to complete hand hygiene to prevent the spread of infection. CNA A stated she had completed a hand hygiene and infection control in-service about two months ago. Page 1 of 2 676243 676243 03/15/2023 Remington Transitional Care of Richardson 1350 E Lookout Dr Richardson, TX 75082

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Record review of Resident #210's face sheet dated 3/15/23 reflected she was [AGE] year old female. She was admitted to the facility on [DATE]. She was admitted with acute kidney failure, type 2 diabetes, altered mental status, hypertension, gout, and acute respiratory failure. Review of Resident #210's care plan initiated 03/07/23 reflected the resident had an ADL self-care performance deficit and the intervention was for the resident to be assisted by staff for toileting. Observation on 03/15/23 at 10:29AM reflected CNA B providing incontinent care to Resident #210. CNA B was observed entering Resident #210's room gloved without any form of hand hygiene and explained to the resident that she was to provide incontinent care. CNA B positioned the resident and unfastened her brief, then proceeded to cleaning the resident. When CNA B had completed cleaning, she took off the dirty brief and placed it on the edge of the bed. Without any form of hand hygiene or change of gloves, CNA B proceeded to apply the clean brief. After CNA B applied the clean brief, she picked up the dirty brief that was at the edge of the bed, and placed it in the trash can. With the same dirty gloves, CNA B covered the resident, positioned the resident, and moved the bedside table closer to the resident. After care, CNA B completed hand hygiene In an interview on 03/15/23 at 12:11 PM with CNA B she stated she was to complete hand hygiene before and after care and after taking off Resident #210's dirty brief. CNA B stated she was supposed to clean her hands when she initially started to provide care, and after she cleaned the resident before applying the clean brief. CNA B also stated she was supposed to take off the dirty gloves before touching the resident's bedding and bed side table. CNA B stated she was to complete hand hygiene for infection control, and she stated she was in-serviced on infection control about a month ago. In an interview on 03/15/23 at 1:05 PM with the DON, she stated infection control was important during care. The DON stated during care the staff were to use the hand sanitizer or wash hands if they were physically soiled. The DON stated the staff were expected to complete hand hygiene before care and after care, she also stated during incontinent care the staff were supposed to change gloves and use hand sanitizer when taking off the dirty brief before applying the clean. The DON stated hand hygiene was to be completed for infection control. DON said she was the infection preventionist and in-service on infection control completed within a month ago. Record review reflected the facility completed an in-service on 02/27/23 for hand hygiene. Review of the facility policy dated 10/24/22 and titled Hand Hygiene reflected, All staff will perform proper hand hygiene procedures to prevent the spread of infection to other personnel, residents, and visitors. This applies to all staff working in all locations within the facility.a. The use of gloves does not replace hand hygiene. If your task requires gloves, perform hand hygiene prior to donning gloves, and immediately after removing gloves. 676243 Page 2 of 2