Every finding on record at Chi - Health Connect at Home - Fargo

Based on observation, record review, professional reference, and staff interview, the facility failed to follow standards of infection control and prevention for 1 of 1 sampled patient (Patient #8) on isolation observed during cares. Failure to practice infection control standards related to enhanced barrier precautions (EBP) has the potential to spread infection to other patients. --- Findings include:Review of the Centers of Disease Control (CDC) guidance at https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos-states-and-cms-locations/enhanced-barrier-precautions-nursing-homes-prevent-spread-multidrug-resistant-organisms-mdros, dated March 20, 2024, titled "Enhanced Barrier Precautions in Nursing Homes to Prevent Spread of Multidrug-resistant Organisms (MDROs)," stated, ". . . [EBP] recommended gown and glove use for certain residents during specific high-contact resident care activities . . . EBP are indicated for residents with . . . wounds and /or indwelling medical devices even if the resident is not known to be infected or colonized with a MDRO. . . . EBP is employed when performing the following high-contact resident care activities: . . . *Changing briefs or assisting with toileting, *Device care or use: . . . urinary catheter . . . *Wound care: any skin opening requiring a dressing . . ."Review of Patient #8's medical record occurred on all days of survey. The plan of care identified an indwelling urinary catheter, nephrostomy tube, and wound to the buttocks.Observation on 07/21/25 at approximately 2:20 p.m. showed two nurses (#1 and #2) entered Patient #8's room in the skilled nursing facility (SNF), which had a supply cart by the door with gowns and gloves. The nurses completed hand hygiene and applied gloves. Observation showed Patient #8 had a urinary catheter, pressure ulcers to his spine and buttocks, and a nephrostomy tube located within an ostomy bag. One nurse (#1) stated staff placed the bag over the nephrostomy tube due to leakage on the patient's skin. The nurse (#1) changed the pressure ulcer dressings and adjusted the nephrostomy tube, and the other nurse (#2) assisted with turning the patient from side to side. The nurses (#1 and #2) failed to apply gowns before providing cares.During an interview on 07/21/25 at 3:20 p.m., a SNF nurse (#3) stated staff used the isolation supply cart for EBP because of Patient #8's open wounds, catheter, and nephrostomy tube. The nurse (#3) stated she expected anyone providing Patient #8's cares to wear a gown and gloves, and the sign on the door of two hands crossed signified EBP. Observation showed this small sign next to Patient #8's nameplate on his door and a large sign by the bathroom sink regarding the need for EBP.During an interview on 07/22/25 at 2:00 p.m., an administrative nurse (#4) stated she expected the Hospice staff to follow any precautions the SNF followed.