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As COVID outbreaks continue in nursing facilities, CMS (Centers for Medicare & Medicaid Services) will be increasing targeted infection control surveys of long-term care facilities. CMS has said it is toughening penalties based on early COVID-19 data trends, as well as on findings of the agency’s targeted infection control inspections. Survey time is stressful for everyone but being prepared and ready can help to be successful. Create a survey book that contains the information surveyors will ask for when they enter the building. In addition to conducting staff interviews, meal observations and kitchen inspections, some areas surveyors may be reviewing include the following:

General:

  • Employees/Vendors are screened prior to entering building for fever or symptoms of COVID-19
  • Posters placed that encourage staff/vendors staying home when sick
  • Policy and procedure in place for adequate staffing to meet the needs of the residents when needed during an emergency, such as COVID-19 outbreak
  • Cough and sneeze etiquette are followed. Signage is placed at the entrance to the kitchen and in other workplace areas where they are likely to be seen.
  • Staff perform proper hand hygiene when indicated
    • Wash hands with soap and warm water for at least 20 seconds
    • Before starting their shift
    • Before putting on personal protective equipment
    • After removing personal protective equipment
    • After encountering any source of contamination
    • After coughing, sneezing or blowing your nose
    • Before putting on gloves and between changing gloves
    • When changing tasks in the kitchen
    • After handling chemicals
    • Before and after breaks
    • After using the restroom
    • Appropriate and enough personal protective equipment available to all employees
    • Employees are using proper personal protective equipment when working in the dish machine area
    • Up to date infection control policies and procedures are being followed
    • Staff training/in-service programs in place for proper infection control in the food service department

Cleaning and Sanitizing:

  • Equipment is cleaned and sanitized properly
  • Proper documentation of cleaning schedules maintained-daily, weekly, and/or monthly
  • Proper procedures are followed for operation of a low or high temperature dish machine
  • “High touch surfaces” are defined and staff clean frequently
  • Sanitizer buckets meet proper concentration and results documented
  • Sanitation audits are conducted routinely
  • Temperature logs (dish machine, refrigerators, freezers, dairy coolers, etc.) are up to date and properly documented

Meal Service:

  • Non-communal dining in place for all residents
  • Test trays are done routinely and documented
  • Food temperatures are logged and corrective actions taken when needed
  • Disaster plan available including a disaster menu

Facilities should have their own unique set of policies and procedures specifically designed by them. By being prepared ahead of time, the stress of survey time can be reduced leading to a successful outcome for all.

References:
https://www.mcknights.com/news/bulletin-cms-ratcheting-up-nursing-home-penalties-in-light-of-26000-resident-450-worker-covid-19-death-toll/
https://www.ahcancal.org/facility_operations/disaster_planning/Documents/self-assessment.pdf