Every finding on record at Continuum Home Health Care of Uva

An unannounced Home Health Agency recertification survey was conducted on March 15-17, 2021 by three (3)Medical Facilities Inspectors from The Office of Licensure and Certification, Virginia Department of Health. In conjunction with this survey, the agency's emergency preparedness plan was reviewed. The agency was found to be in compliance with 42 CFR 484.102 Conditions of Participation Emergency Preparedness for Home Health Agencies.

An unannounced Home Health recertification survey was conducted March 15-17, 2021 at the above noted agency by three (3) Medical Facilities Inspectors from The Office of Licensure and Certification, Virginia Department of Health. The survey occurred both onsite and remotely due to the COVID-19 Public Health Emergency. Deficiencies were identified and cited in this report. The agency was found not to be in compliance with the federal requirements of 42 CFR 484, Conditions of Participation for Home Health Agencies.

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 staff observation, policy and procedure review, and staff interview, it was determined the agency failed to follow standards of practice to prevent the transmission of infections and communicable diseases. Specifically, the Skilled Nurse failed to maintain sterile technique during the dressing change of a Peripherally Inserted Central Catheter (PICC) for one (1) of one (1) patients' whose PICC care was observed during a home visit conducted by the Medical Facilities Inspector (MFI). Findings: Two (2) Medical Facilities Inspectors (MFI) conducted seven (7) home visits on 03/16/2021. 1. The MFI conducted a home visit at the residence of Patient #11 to observe care provided by the agency Skilled Nurse (SN) on 03/16/2021 at 9:00 AM. The Assistant Nurse Manager, Staff Member #5, accompanied the MFI on the home visit. Patient #11 had a start-of-care (SOC) date of 02/11/2021 and a primary diagnosis of infection and inflammatory reaction due to other internal joint prosthesis. Patient #11's plan of care (POC), contained the following physician order for the dressing change of the Peripherally Inserted Central Catheter (PICC) in the patient's left arm - a PICC is a tube inserted into a large vein in the arm used to administer intravenous (IV) medications: IV dressing change....Using aseptic technique remote [sic- remove] old dressing. Clean access site with a 30 second chlorhexidine scrub [chlorhexidine is a topical antimirobial drug used to cleanse the skin]. Apply catheter stabilization device: Statlock as needed. Apply transparent film dressing. Change IV site dressing, injection cap(s), and extension set(s) weekly and as need to maintain dressing integrity. During the MFI's observation of the SN's PICC site dressing change, the SN applied sterile gloves prior to completely removing the soiled dressing and then proceeded to touch the soiled dressing with the sterile gloves. The SN then applied a second set of sterile gloves, touched the soiled dressing, and then proceeded to use materials from the sterile field including a chlorhexidine scrubbing device and a sterile transparent dressing. The SN failed to maintain sterile technique while performing the PICC site dressing change. The MFI requested the agency's policy and procedure for PICC dressing changes on 03/16/2021 from the Assistant Nurse Manager at approximately 9:30 AM. The Assistant Nurse Manager provided a policy and procedure titled "Peripherally inserted central catheter (PICC) dressing change, home care." The policy contained the following information: "PICC dressing changes require sterile technique to reduce the risk of vascular catheter-associated infection." The MFI interviewed the Assistant Nurse Manager on 03/16/2021 at 11:00 AM regarding the above-noted observation during the home visit conducted at the residence of Patient #11. The MFI asked the Assistant Nurse Manager if sterile technique was required during PICC dressing changes. The Assistance Nurse Manager stated, "Yes." The MFI asked the Assistant Nurse Manager if the SN maintained sterility during the PICC site dressing change during the home visit as directed in the agency's policy and procedure for PICC site dressing changes. The Assistant Nurse Manager stated, "No." The MFI asked the Assistant Nurse Manager if the SN failing to follow the agency's policy and procedure for PICC dressing care resulted in increased risk of infection. The Assistant Nurse Manager acknowledged that failing to provide PICC site dressing changes using sterile technique was an infection control risk. The above-noted deficiency was acknowledged during an interview with the Assistant Nurse Manager on 03/16/2021 and again during the exit conference on 03/17/2021 by the Administrator, Staff Member #4, and the Clinical Manager, Staff Member #3.