Feel at Home Assisted Living

Based on documentation review, record review, observation, and interview, the healthcare institution failed to implement tuberculosis (TB) infection control by obtaining the two-step testing for health care personnel upon hire as specified in R9-10-113, and as recommended by the CDC. 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)...c. Annually providing training and education related to recognizing the signs and symptoms of tuberculosis to individuals employed by or providing volunteer services for the health care institution; d. Annually assessing the health care institution's risk of exposure to infectious tuberculosis..." 2. A review of the Centers for Disease Control and Prevention (CDC) 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 E2's personnel record revealed E2 worked as a caregiver and had a hire date of December 6, 2023. The Compliance Officer observed a TB document titled "Baseline TB Screening Tool for Assisted Living Resident/Employee". The document included an assessment of symptoms and one TB test dated 10/12/2023, however, no documentation of a second TB test given to R2 before R2 began assisted living services with residents. 4. A review of E3's personnel record revealed E3 worked as a caregiver and had a hire date of October 9, 2023. The Compliance Officer observed a TB document titled "Baseline TB Screening Tool for Assisted Living Resident/Employee". The document included an assessment of symptoms and one TB test dated 10/10/2023, however, no documentation of a second TB test given to R3 before R3 began assisted living services with residents. No other documentation was available for review during the compliance survey. 5. In an interview, E4 acknowledged E2, and E3 did not have a second TB documented in their personnel record.