Nursing homes inspected for infection-control practices during the pandemic revealed deficiencies, including failure to separate COVID-positive residents from residents who do not have the virus, improper use or no use of personal protective equipment (PPE), failure to practice good hygiene and handwashing and the improper sanitation of equipment.
One facility was cited for allowing an assistant director of nursing, who tested positive for COVID, to work for five days. Plans of correction were submitted by each home. None of the facilities were fined.
The unannounced, in-person inspections resulted in enhanced staff training and additional deliveries of personal protective equipment (PPE), according to the Department of Public Health (DPH). During the pandemic, health care workers have complained about a lack of PPE, having to reuse their equipment.
Here’s a summary of the homes and the violations:
• Abbott Terrace Health Center of Waterbury was cited for failing to ensure that residents wore masks outside of their rooms and that residents maintained social distancing while outside their rooms.
• A registered nurse at Apple Rehab Coccomo of Meriden was observed not wearing a mask while walking through the facility and a nurse aide entered a unit without wearing a mask or face covering. Yellow gowns were found hanging outside rooms of residents rather than inside.
• Avon Health Center was cited for failing to ensure that a curtain was drawn between a resident who was awaiting the results of a COVID-19 test and a resident who did not have the virus.
• An inspector observed a certified nursing assistant exit a resident’s room at Bayview Health Care in Waterford without wearing the proper PPE. Also, the inspection found the potential cross-contamination of monitoring devices, such as the oxygen saturation scanner, which was set down on a table after use, cleaned, but then returned to the table which was not cleaned.
• Beacon Brook Health Center of Naugatuck was cited for allowing several residents to eat meals together, when communal dining should have been stopped.
• An inspector found that Bethel Health Care failed to separate residents with the virus from residents without the virus and that a nurse aide used the same PPE while caring for COVID and non-COVID residents.
• At Cassena Care, New Britain, an inspector found that the facility failed to ensure that room curtains were drawn between residents’ beds.
• At Countryside Manor, Bristol, a transportation service crew was observed removing a COVID resident from the COVID-positive wing through a non-infected wing without proper facial covering for the resident.
• During an inspection at Evergreen Health Care Center, Stafford Springs, a housekeeping staff member was observed removing soiled linen bags from soiled linen carts without wearing protective equipment, including a gown. The linens hit rubbed against the staffer’s body.
• Fox Hill Center of Rockville was cited for failing to notify a responsible party when a resident’s condition changed.
• Groton Regency Center was cited after an inspector observed that the dietary manager was not practicing proper hand hygiene when working in the facility.
• A licensed practical nurse at Madison House was observed exiting a resident’s room and placing a used face shield on a cart that contained PPE.
• Nathaniel Witherell of Greenwich was cited for failing to have signage outside a room indicating that a COVID-19 test was pending.
• RegalCare at New Haven was cited for the incorrect use of PPE, for not having enough PPE, and for not checking staff members’ temperatures before allowing them to enter the work area.
• A staff member at St. Camillus Rehabilitation & Nursing Center, Stamford, was observed leaving a room that has a droplet precaution sign on door and proceeding down the hallway and then removing the gown and gloves. Staff should have removed PPE inside the room before exiting.
• An inspection found that an assistant director of nursing at The Suffield House worked for five days at the nursing facility despite testing positive for COVID-19. Inspector wrote “she reported to work in the long-term care facility for five days and potentially placed other staff and residents at risks for contracting coronavirus.”
• Twin Maples Healthcare in Durham was cited for staff members’ incorrect usage of protective eyewear while caring for a resident who was on droplet transmission-based isolation. The resident was a recent admission to the facility. The home was also cited for a housekeeper’s practice of touching a soiled utility-room doorknob and then touching clean linens; and for the mixing of clean and used incontinence briefs.
• West Hartford Health & Rehabilitation was cited for failing to separate a COVID-positive resident from a resident who did not have COVID.
• An inspector observed a licensed practical nurse at Windsor Health & Rehabilitation Center working at a medication cart without wearing a mask. The LPN indicated that she did not need to wear a mask because she had recovered from coronavirus, but was told that all staff need to wear masks.
In response to the inspection findings, Matt Barrett, president and CEO of the Connecticut Association of Health Care Facilities, and Mag Morelli, president of LeadingAge Connecticut wrote in a press release, “We believe Connecticut nursing homes are performing at an extraordinary level given the challenges of fighting this insidious virus while faced with changing guidance, an inadequate PPE supply chain and a statewide testing initiative that has only recently begun. And while we would prefer that these focused inspections did not result in any findings, we absolutely welcome the Department’s oversight and efforts in ensuring that Connecticut nursing home infection control procedures are in adherence with the latest of what has been ever-changing CDC guidance.”
This week, Dr. Deidre Gifford, acting commissioner of public health and commissioner of the Department of Social Services, said that the state is conducting a “point prevalence surveys in every nursing home and testing every resident” to better understand the high rate of infections.
The testing is also being done to provide information to facilities so that they can cohort COVID positive residents from residents who are virus free, which will further decrease the chance of spread, Gifford said.
On Monday, the Centers for Medicare & Medicaid Services issued new guidelines for the reopening of nursing homes. CMS recommends “baseline” testing of residents (which CT is doing) and staff followed by weekly testing of staff. Facilities should ensure that they have adequate protective gear. CMS also recommends that nursing homes be “among the last” of entities in the state to reopen. The guidelines are nonbinding, leaving it up to each state to determine when nursing homes should be reopened to visitors.
CORRECTION: An earlier version of this story reported that Twin Maples Healthcare in Durham had a COVID resident. It does not.