Nazareno Home Care

“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 observation and police and procedure reviewed, four (4) home visits (H.V) performed on 12/16/2025 through 12/17/2025 in company of Registered Nurse and Licensed Practical Nurse (employees #4, #5 and #6), it was determined that the facility failed to ensure that the Registered Nurse (RN) complies with standard practice precautions to prevent the transmission of infectious agents for 3 out of 4 home visits during the local wound care, urinary catheter insertion procedure and bed bathing. (H.V #1, #3 and H.V #4) Findings include: The facility provided a policy named LAVADO DE MANOS hand washing, that was reviewed on 12/17/2025 at 1:50 PM with the services director (employee #2), states that the nurse must wash their hands before and after patient care, before touch the face or mouth of the patient, after touch urine, bandage or dirty areas and the time for the washing must be for 45 to 60 seconds. Also states that the order for the hand washing is open the faucet first, the put soap on their hands and then proceed to wash the hands. The facility provided a policy named POLITICA DE PREVENCION DE INFECCIONES: EQUIPO PROTECTIVO Y PRECAUCIONES UNIVERSALES Infection prevention policy: protective equipment and universal precautions, that was reviewed on 12/17/2025 at 1:56 PM with employee #2, states that the equipment to be use in the patients must be disinfected before storage it. The facility provided a policy named Procedimientos antes de la intervención before intervention procedures, that was reviewed on 12/17/2025 at 1:58 PM with employee #2, states that the nurse must wash her hand at least 45 seconds before start intervention with the patient and at least 10 seconds after completing the intervention with the patient. The facility provided a policy called Baño bath, that was reviewed on 12/17/2025 at 2:09 PM with employee #2, states that the nurse should start from the cleanest area and work their way to the dirtiest, starting from the head and ending with the genitals. It also indicates that the nurse should change the water when moving from one area of the body to another. 1. HV #1 is an 80-year-old male admitted on 10/31/2025 with a diagnosis of Unspecified open wound in right foot. The patient was visited on 12/16/2025 at 10:39 AM until 11:09 AM accompanied by a registered nurse from the facility (employee #4). During the visit the patient was observed to be alert and oriented. The patient was being visited by employee #4 to provide wound care. However, the following was observed: a. Employee #4 washed her hand before starts the intervention with the patient, but the procedure wasn’t in the correct order. She put soap in her hands, then open the faucet and the time washing her hands was for 13 seconds. b. Employee #4 failed 5 out of 6 opportunities of hand hygiene. 2. HV #3 is a 74-year-old male admitted on 11/07/2025 with a diagnosis of encounter for attention of cystostomy. The patient was visited on 12/17/2025 at 8:36 AM until 9:06 AM accompanied by a registered nurse from the facility (employee #5). During the visit the patient was observed to be alert and oriented. The patient was being visited by employee #5 to provide urinary catheter change. However, the following was observed: a. Employee #5 washed her hand before starts the intervention with the patient, but the time washing her hands was for 15 seconds. b. Employee #5 made one glove change without hand hygiene. c. Employee #5 failed 2 out of 5 opportunities of hand hygiene. 3. HV #4 is a 95-year-old female admitted on 11/28/2025 with a diagnosis of pressure ulcer of sacral region stage 2. The patient was visited on 12/17/2025 at 10:03 AM until 10:43 AM accompanied by a licensed practical nurse from the facility (employee #6). During the visit the patient was observed to be alert, disoriented and bedridden. The patient was being visited by employee #6 to provide bed bathing. However, the following was observed: a. Employee #6 washed her hand before starts the intervention with the patient, but the time washing her hands was for 6 seconds. b. The order of the bathing that the employee #6 employed was: genital area, upper body area, lower body area, face and mouth wash, without change of water neither change of gloves. c. After the bath, the employee #6 took the vital signs of the patient without disinfect the equipment before or after. d. Employee #6 did not wash her hands after completing the intervention with the patient. e. Employee #6 omitted 3 gloves changes. f. Employee #6 failed 7 out of 7 opportunities of hand hygiene. The educations, annual evaluations and competences of the employees #4, #5 and #6 were evaluated with employee #2 on 12/17/2025 at 1:14 PM and they were made and oriented.”

“Property and person treated with respect CFR(s): 484.50(c)(1) Have his or her property and person treated with respect; This Element is not met as evidenced by: Based on observation and police and procedure reviewed, four (4) home visits (H.V) performed on 12/16/2025 through 12/17/2025 in company of Registered Nurse and Licensed Practical Nurse (employees #4, and #6), it was determined that the facility failed to ensure that the Registered Nurse (RN) and the Licensed Practical Nurse (LPN) complies with standard practice of patient privacy during a procedure. (H.V. #1 and #4) Findings include: The facility provided a policy named Procedimientos antes de la intervención before intervention procedures, that was reviewed on 12/17/2025 at 1:58 PM, states that the nurse must provide privacy to the patient, positioning it and covering up. The facility provided a policy called Baño bath, that was reviewed on 12/17/2025 at 2:09 PM, states that the nurse should avoid exposing the patient. 1. HV #1 is an 80-year-old male admitted on 10/31/2025 with a diagnosis of Unspecified open wound in right foot. The patient was visited on 12/16/2025 at 10:39 AM until 11:09 AM accompanied by a registered nurse from the facility (employee #4). During the visit the patient was observed to be alert and oriented. The patient was being visited by employee #4 to provide wound care. However, the following was observed: a. The treatment procedure was carried out in the living room with the front door open, allowing visibility to people outside the home. Employee #4 did not ask for or provide privacy during the procedure. 2. HV #4 is a 95-year-old female admitted on 11/28/2025 with a diagnosis of pressure ulcer of sacral region stage 2. The patient was visited on 12/17/2025 at 10:03 AM until 10:43 AM accompanied by a licensed practical nurse from the facility (employee #6). During the visit the patient was observed to be alert, disoriented and bedridden. The patient was being visited by employee #6 to provide bed bathing. However, the following was observed: a. The room door was clear, but has a curtain to provide privacy, however, the employee #6 did not close the curtain. b. During the bed bathing, the employee #6 exposed parts of the patient’s body that she was not cleaning.”