Why Infection Control Remains a Top Concern in Home Health
July 26, 2025
Infection control is a crucial area of focus during home health accreditation surveys. Surveyors assess written policies and procedures and shadow clinicians on patient home visits to observe implementation of the practices that prevent infections and reduce risk. Depending on severity, infection control breaches may be reportable to state public health authorities, and these issues have been among some recently cited survey deficiencies. Understanding where home health agencies may fall short and actively addressing issues is essential for compliance and quality care.
Observed infection control breaches
- Errors in hand hygiene: Surveyors have observed clinicians failing to perform hand hygiene before and after patient contact or after touching potentially contaminated surfaces. Inconsistent availability of appropriate hand washing supplies can also lead to citations. Examples include using a patient’s bar soap and cloth bath towel rather than liquid soap and paper towels or alcohol-based hand sanitizer.
- Lack of personal protective equipment (PPE): Surveyors expect PPE use to align with agency policy and patient care needs. Common findings include failure to wear gloves (e.g., during wound care), absence of masks during respiratory procedures, or incorrect donning and doffing of PPE.
- Incorrect bag technique: How clinicians manage their bag of supplies and equipment—placement, use of necessary barriers, disinfection of multiuse items like blood pressure cuffs, stethoscopes, and thermometers—relates directly to infection prevention. If staff cannot correctly demonstrate these practices, it can result in survey deficiencies.
- Wound care: This high-risk area receives significant attention during surveys. Surveyors are likely to observe dressing changes and review documentation. Expired supplies, incorrect or missed dressing changes, and lack of proper technique for wound care often trigger citations.
- Improper handling of sharps: Surveyors check that clinicians follow safe injection practices for single-use items, disposal of sharps in approved containers, and relevant safety education for patients when sharps are used in the home.
Tips for improved compliance
- Review your policies and procedures: Verify that your infection control policies are up to date, reflecting the latest industry guidance, and comprehensive, addressing the scope of services you provide. Ensure that your staff has access to the policies and can demonstrate compliance through actual field practice.
- Train your staff : Provide infection control training at orientation and at least annually. Document the training for each individual staff member.
- Stock supplies: Provide clinicians with the proper PPE, hand washing materials, disinfectants, and sharps containers. Surveyors may ask to see your office supply or staff members’ car stocks.
- Use mock surveys: Direct observation of clinicians in the field or through simulated home visits in the office provide opportunities to verify compliant hand hygiene, PPE use, bag technique, wound care, and sharps handling. Provide immediate feedback and reinforce correct techniques.
Infection control compliance goes beyond policies, procedures, and clinical record documentation. It requires demonstration of adequate, observable, infection control practices in the home setting. By addressing common issues proactively, with ongoing staff education and regular internal audits, home health agencies can promote survey success while reducing risk for patients and clinicians, while improving quality of the care they provide.
By: Becky Tolson, RN, BS
Manager, Survey Operations
Posted: June 20, 2025
If your agency is cited for failed infection control practices, call Kenyon HomeCare Consulting at 206 721 5091 or email gkenyon@kenyonhcc.com for assistance.
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Today, this article will look at little different than out typical articles. We all know the costs of losing employees and trying to hire and train new ones. It is exhausting and expensive. So, we think about our wages and benefit packages all the time. What can we do differently that makes people stay? We can’t change the job and we don’t want to keep people that don’t like the work itself. So, how do we acknowledge employees in a way that is valuable to them and that our businesses can afford to do? 5 Things To Consider About Employee Recognition At Your Christmas Party: 1. Years of Service: These can be based on milestone work anniversaries (5, 10, 15 yrs, etc.). If a person has been at your agency 11 years, you pull them up and acknowledge them in the group of employees who have been there at least 10 years up until the time they hit the 15 years landmark. This way longevity is recognized yearly. 2. Special Employee awards: Now, this may be difficult if your staff is very small, but acknowledge the employee who has gone the extra mile in the job they do. Tell the story. The employee needs to know when the employer is proud of the work that has been done. Consider a plaque or certificate. Don’t minimize the value of the employee having them to display. 3. Acknowledge all employees in the mix: Because we are a clinical industry, the administrative staff is often overlooked on day-to-day operations. Ultimately, don’t miss the chance to acknowledge the employee who was able to catch billing errors or collect on a large account. Staff doesn’t like to hear about money, but those types of collections keep Christmas bonuses in place! So, make sure the other staff knows the accomplishments of the finance department or the office manager that every caller loves to speak to. Don't ever forget the IT staff that is on call more than any clinical person in your agency! 4. Letters from the administration: Add a personal note to your staff either collectively or individually depending on the size of your agency. If you are larger, there are employees you don’t often see or get to talk to on a regular basis, so take the time so send a note with that Christmas bonus. 5. Consider the Christmas bonus: Listen, some of you can afford to do substantial monetary bonuses and that is fantastic. However, if you are not in that position, consider something in its place. Maybe small gas cards go with the letter from administration. With the cost of groceries, consider something that helps with the costs of daily living for employees. Big box gift cards in your area will always be used. You may do a lot of these things on a yearly basis to employees. All this being said, it doesn’t mean there aren’t reasons for acknowledgement throughout the year. However, your annual Christmas party is a good way to do it collectively. Between your annual party, write the individual cards to employees when you hear a patient interaction worthy of praise. Or, maybe you buy a gas card for the employee who has picked up extra shifts and always shows up on time. Ultimately, employees will feel valued. You will not regret the time, effort, and energy put into these efforts. Merry Christmas! If you want help with recruitment and retention strategies for your agency, please call Kenyon Homecare Consulting at 206-721-5091 or contact us online today.