Mountain Home Health Care, Inc.

“Infection Prevention CFR(s): 484.70(a) Standard: Infection Prevention. The HHA must follow accepted standards of practice, including the use of standard precautions, to prevent the transmission of infections and communicable diseases. This Standard is not met as evidenced by: Based on observations, interviews and record review, the facility failed to ensure infection prevention practices were followed during home health visits for 1 (Patient (P)10) of 4 (P7, P8, P9, and P10) patients observed receiving home healthcare visits. This deficient practice could likely result in patients receiving home health care that can expose the patients to potentially infectious pathogens (organisms that can lead to illness). The findings are: A. During an observation on 02/11/25 at 1:04 pm, S (Staff)1 clinical placed a portable medical equipment bag and stethoscope (a medical device used to listen to a person’s heart, lungs and other parts of the body) on P10’s dining table without use of an infectious control barrier such as paper towels, newspapers, trash bags, etc. used as a protective barrier for bag placement in the patient/client’s home. B. During an observation on 02/11/25 at 1:14 pm, S1 performed wound care dressing change, then placed the soiled dressings on a paper cloth barrier, removed the contaminated exam gloves used for the dressing change and placed the gloves on top of the paper cloth following the completion of wound care. S1 used both bare hands to pick up the paper cloth barrier which held the soiled dressings, contaminated gloves and disposed of the contaminated items into a trash bag without performing hand washing or hand sanitation after contact with the contaminated items. C. During an interview with S1 on 02/11/25 at 1:59 pm, S1 was asked what the facility’s policy is on bag technique for prevention of cross-contamination in the patient’s homes. S1 replied “Oh shoot, I forgot to place a barrier under my bag and supplies. I did place one under P10’s foot, though. I forgot to do that for my bag.” When S1 was asked what the facility’s policy is regarding hand hygiene, S1 relied “I forgot to do that, too. Please don’t be hard on me. I messed up.” D. Record review of facility’s policy titled “Administrative Policy Manual Bag technique: with last review date of 11/01/2020 stated the following: “Purpose: To describe the procedure for maintaining a contaminate [sic] free home health bag and prevent cross-contamination. Policy: The principles in bag technique are developed and used to maximize the efficient use of the bag and to assure asepsis and the control of infection. Procedure: II. Bag Technique A. …In the patient/client home, a barrier (such as newspaper, paper towel, small trash bag, etc.) is to be placed under the bag. E. Paper towels, newspapers, trash bags, etc. used as a protective barrier for bag placement in the patient/client’s home will be disposed of properly. E. Record Review of the facility’s policy titled “Administrative Policy Manual, Hand Hygiene” with last review date of 01/14/23 stated the following: II. Hand hygiene with an alcohol-based rub Staff will apply product to the palm of on hand A. Staff will rub hands together covering all surfaces of hands and fingers, until hands are dry. This should take about 20 seconds. B. The manufacturer’s recommendations will be followed regarding the volume of the product use. C. Unless hands are visibly soiled, alcohol-based rub is preferred over soap and water in most clinical situations due to evidence of better compliance compared to soap and water. Staff may use alcohol-based rub for routinely decontaminating hands in the clinical situations described below: …2. Immediately before and after touching a patient …4. After contact with body fluids or excretions, mucous membranes, nonintact skin, and wound dressings and used supplies (PPE) if hands are not visibly soiled”