Casa Companion Homecare LLC

Based on record review and interview, the manager failed to ensure a service plan included skin maintenance to prevent and treat bruises, injuries, pressure sores, and infections, for two of two residents reviewed. Findings include: 1. A review of R1's medical record revealed a service plan, dated October 4, 2023, for personal care services. However, the service plan did not include skin maintenance to prevent and treat bruises, injuries, pressure sores, and infections. 2. A review of R2's medical record revealed a service plan, dated July 9, 2023, for personal care services. However, the service plan did not include skin maintenance to prevent and treat bruises, injuries, pressure sores, and infections. 3. In an interview, E1 acknowledged R1's and R2's services plan did not include a description of the skin maintenance each resident required to prevent and treat bruises, injuries, pressure sores, and infections.

Based on record review and interview, the manager failed to ensure a resident provided evidence of freedom from infectious tuberculosis (TB) as specified in R9-10-113, for two of two employees reviewed. Findings include: 1. R9-10-113.A states "If a health care institution is subject to the requirements of this Section, as specified in an Article in this Chapter, the health care institution's chief administrative officer shall ensure that the health care institution establishes, documents, and implements tuberculosis infection control activities that...2. Include: a. For each individual who is employed by the health care institution, provides volunteer services for the health care institution, or is admitted to the health care institution and who is subject to the requirements of this Section, screening, on or before the date specified in the applicable Article of this Chapter, that consists of: i. Assessing risks of prior exposure to infectious tuberculosis, ii. Determining if the individual has signs or symptoms of tuberculosis, and iii. Obtaining documentation of the individual's freedom from infectious tuberculosis according to subsection (B)(1)..." 2. A review of the Centers for Disease Control and Prevention website revealed a web page titled "TB Screening and Testing of Health Care Personnel." The web page stated, "If the Mantoux tuberculin skin test (TST) is used to test health care personnel upon hire (preplacement), two-step testing should be used." 3. A review of E1's personnel record revealed a baseline screening form, signed by a medical practitioner, containing a risk assessment and symptom screen and a single TST. However, documentation of the second step of the recommended two-step TST was not available for review. 4. A review of E2's personnel record revealed a baseline screening form, signed by a medical practitioner, containing a risk assessment and symptom screen and a single TST. However, documentation of the second step of the recommended two-step TST was not available for review 5. In an interview, E1 acknowledged E1 and E2 did not provide documentation of freedom from infectious TB as specified in R9-10-113.

Based on record review and interview, the manager failed to ensure a resident provided documentation of freedom from infectious tuberculosis (TB) as specified in R9-10-113, for two of two residents reviewed. Findings include: 1. R9-10-113.A states "If a health care institution is subject to the requirements of this Section, as specified in an Article in this Chapter, the health care institution's chief administrative officer shall ensure that the health care institution establishes, documents, and implements tuberculosis infection control activities that...2. Include: a. For each individual who is employed by the health care institution, provides volunteer services for the health care institution, or is admitted to the health care institution and who is subject to the requirements of this Section, screening, on or before the date specified in the applicable Article of this Chapter, that consists of: i. Assessing risks of prior exposure to infectious tuberculosis, ii. Determining if the individual has signs or symptoms of tuberculosis, and iii. Obtaining documentation of the individual's freedom from infectious tuberculosis according to subsection (B)(1)..." 2. A review of R1's medical record revealed documentation of a negative skin test for TB within one year prior to admission or within seven days after admission. However, baseline screening documentation to include a risk assessment of prior exposure to infectious TB and a determination if R1 had signs or symptoms of TB, signed by an occupational health provider or medical practitioner, was not available for review. Based on R1's acceptance date, this documentation was required. 3. A review of R2's medical record revealed documention of a negative skin test for TB within one year prior to admission or within seven days after admission. However, baseline screening documentation to include a risk assessment of prior exposure to infectious TB and a determination if R2 had signs or symptoms of TB, signed by an occupational health provider or medical practitioner, was not available for review. Based on R2's acceptance date, this documentation was required. 4. In an interview, E1 acknowledged R1 and R2 had not provided documentation of baseline screening as specified in R9-10-113.