Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 110 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF SKILLED NURSING FACILITIES AND NURSING FACILITIES › Section 144-110-21 - Infection Control and Biomedical Waste

Current through 2024-29, July 17, 2024
21.A.
Infection Control
The facility must establish an active program for the
				  prevention, control, and investigation of infection according to current
				  standards and federal Center for Disease Control ("CDC") guidelines, which
				  includes:
21.A.1. The facility's
				written protocols for the prevention of the spread of infections shall require
				consultation with the Maine Center for Disease Control and Prevention ("MeCDC")
				for any mandatory reportable disease as required by 10-144 CMR Ch. 258, Control
				of Notifiable Diseases and Conditions Rule, within 24 hours of any resident or
				staff person exhibiting symptoms of such a disease, and within 12 hours of any
				confirmed positive resident or staff person. This consultation with the MeCDC
				must include consideration of universal testing and resident cohorting.
				Facilities shall notify the DHHS Division of Licensing and Certification
				("DLC") prior to implementation of universal testing and cohorting.
21.A.2. A written Crisis Staffing plan that,
				at a minimum, includes a clear process to recruit personnel that is not reliant
				on National Guard or government resources as the primary or secondary sources
				for crisis staffing. The staffing plan should outline a progression of facility
				interventions to address staffing needs at various steps in the progression of
				a disease outbreak.
21.A.3. A
				protocol for early identification, reporting, and monitoring of infections
				(nosocomial and those present on admission) that will:
a. Identify residents at risk;
b. Maintain a separate record of infections
				that identifies the resident's name, date of infection, causative agent, origin
				or site of infection, and cautionary measures taken;
c. Prevent infections common to nursing
				facility residents (e.g., vaccination for influenza and pneumococcal pneumonia
				as appropriate);
d. Analyze the
				clusters and/or significant increases in the rate of infection;
e. Report to appropriate agencies those
				infections for which reporting is mandated.
f. Require the facility to notify the MeCDC,
				all other residents and their primary family contact, staff, and DLC of a
				probable or confirmed case of a contagious infection in a resident or staff
				member within 24 hours.
21.A.4. A protocol for prevention of the
				spread of infection that requires:
a. The
				facility must isolate the resident when the infection control program
				determines that a resident needs isolation to prevent the spread of
				infection.
b. The facility may only
				restrict visitation and departures consistent with CDC and MeCDC
				guidelines.
c. The facility must
				establish reasonable methods and processes to allow residents to communicate in
				ways that maintain resident safety consistent with CDC guidelines. Such methods
				could include, but are not limited to, the use of electronic video conferencing
				and visual visitation on-site through closed windows, supplemented with
				telephones.
d. The facility must
				monitor staff infections and prohibit employees with a communicable disease or
				infected skin lesions from direct contact with residents' food.
e. During an infection outbreak, the facility
				must screen all individuals upon entry through a designated entrance of the
				facility. This screening must be done using the most current CDC screening
				methods.
f. The facility must have
				PPE sufficient to last for 72 hours on hand at all times and report PPE
				resources to the MeCDC in the format and frequency specified by the
				MeCDC.
g. The facility must ensure
				adherence to CDC guidance on the use of PPE and source control
				measures.
h. The facility must
				require staff to wash their hands after each direct resident contact for which
				handwashing is indicated by accepted professional practice (per CDC
				guidelines).
i. The facility must
				conduct cleaning and sanitation using cleaning agents and processes consistent
				with federal guidance.
21.A.5. An active training program that
				provides staff and residents, as appropriate, adequate information to prevent
				the spread of infection.
21.A.6.
				Routine review of infectious disease surveillance and recommendations made by
				the facility's Quality Assurance Committee.
21.A.7 The facility must have (employed or
				through contract) an Infection Preventionist whose qualifications are
				consistent with
				42 CFR §
											483.80(b), who is
				responsible for the facility's infection control program. The Infection
				Preventionist shall:
a. Ensure that staff
				have received training and demonstrated competency in appropriate PPE selection
				and utilization, to include donning/doffing processes consistent with current
				CDC guidelines;
b. Conduct random
				visual observations of staff use of PPE. These visual observations shall occur
				at least weekly. Each shift (days, evenings, nights) shall be observed at least
				once a month during an infection outbreak, then quarterly after there is
				documentation that all staff are sufficiently trained and observed competent in
				PPE use; and
c. Take immediate
				corrective actions (to include applicable retraining of staff) to prevent
				cross-contamination.