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. 


ACHC 

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. 


Results Based Consulting

Did you find value in this blog post? Imagine what we can do for your home care or hospice agency. Fill out the form below to see how we're leading the industry with innovation, affordability, and experience.

Contact Us

improve care
By Ginny Kenyon August 15, 2026
In an era of rising healthcare costs and widespread clinician burnout, healthcare organizations are facing a critical challenge: how to deliver superior patient care while maintaining a stable, motivated workforce and a thriving business model.
Stroke training
By Ginny Kenyon August 12, 2026
When a patient returns home after a stroke, the clinical landscape changes instantly. Survival is just the first hurdle; the real challenge lies in navigating the complex, often unpredictable journey of rehabilitation and long-term care. For home health and home care agencies and senior care facilities, caring for a stroke survivor requires more than help with Activities of Daily Living (ADLs). Stroke can affect a patient’s neurological, physical, and emotional functioning simultaneously. That’s why specialized, stroke-specific clinical training for caregivers is essential to improving patient outcomes, supporting staff retention, and strengthening the agency’s overall performance. The Multidimensional Complexity of Post-Stroke Care A stroke is not a singular event with a linear recovery path. Depending on the location and severity of the brain injury, caregivers may confront a baffling array of concurrent deficits: Physical and Motor Deficits: Hemiparesis (one-sided weakness) or hemiplegia (one-sided paralysis) completely alters transfer techniques. Improperly moving a patient can cause severe shoulder subluxation or skin tears. Cognitive and Communication Barriers: Aphasia (difficulty speaking or understanding speech) and dysphagia (swallowing difficulties) require immense patience and highly specific intervention techniques to prevent profound frustration or life-threatening aspiration pneumonia. Neurobehavioral Changes: Sudden emotional lability, post-stroke depression, or structural personality changes can easily overwhelm an untrained caregiver, leading to burnout or adversarial dynamics in the home. Without structured education, caregivers are left to rely on intuition. In complex neurological care, intuition is rarely enough to prevent adverse events. 4 Strategic Benefits of Specialized Stroke Education Investing in robust stroke-specific training programs transforms an agency's frontline staff from general monitors into clinical assets. 1. Drastic Reduction in Hospital Readmissions The first 30 to 90 days post-discharge are high-risk windows for stroke survivors. Educated caregivers act as the eyes and ears of the clinical team. They are trained to look past basic symptoms and identify subtle warning signs early: Recognizing micro-signs of silent aspiration during meals. Monitoring for deep vein thrombosis (DVT) in affected limbs. Identifying skin breakdown early on the hemiplegic side. Spotting the warning signs of a secondary stroke using the B.E. F.A.S.T. protocol (Balance, Eyes, Face, Arms, Speech, Time). Early identification allows for timely home health or physician interventions, keeping the patient safe at home and protecting the agency's rehospitalization metrics. 2. Safeguarding Staff and Patients (Risk Mitigation) The process of transferring a patient with dense hemiparesis requires precise biomechanical knowledge. Specialized education teaches caregivers how to support the affected side without pulling on weakened joints, how to properly utilize assistive devices (gait belts, sit-to-stand lifts), and how to manage one-sided neglect (where a patient completely forgets one side of their body exists). Proper training mitigates the risk of catastrophic falls and shields caregivers from debilitating musculoskeletal injuries, directly lowering workers' compensation claims and liability exposure. 3. Boosting Staff Retention and Professional Empowerment High turnover in caregiving is often caused by burnout and feeling unprepared for challenging cases. When an agency provides specialized clinical training, helping staff understand stroke-related behaviors and advanced transfer methods, it strengthens the caregiver’s role. Staff members feel empowered, confident, and valued as professionals rather than viewed as standard domestic labor. This professional dignity translates directly into higher job satisfaction and improved staff retention. 4. A Powerful Market Differentiator In a crowded marketplace, families and hospital discharge planners look for specialized expertise. An agency that can explicitly state, "Our caregiving staff undergoes advanced, competency-verified training in post-stroke neurological care, dysphagia management, and transfer safety," holds a massive competitive advantage. It builds immediate trust with families and establishes preferred provider relationships with local health systems and stroke centers. Building a Competency-Based Training Framework Effective stroke education cannot be a passive, check-the-box exercise. To truly impact care quality, an agency's training framework should combine foundational knowledge with hands-on validation: Neurological Fundamentals Core Focus Areas: Types of strokes, one-sided neglect, emotional lability, and aphasia communication strategies. Competency Verification: Written scenario analysis and communication roleplay. Mobility & Safety Core Focus Areas: Safe transfers (bed to chair), handling the flaccid or spastic limb, fall prevention, and skin integrity. Competency Verification: Hands-on return demonstration with a mechanical lift/gait belt. Nutritional Security Core Focus Areas: Dysphagia precautions, recognizing pocketed food, fluid thickening consistency, and aspiration prevention. Competency Verification: Direct observation of meal prep and feeding techniques. Conclusion: An Investment in Excellence The care of a stroke survivor is inherently complex, demanding, and volatile. Expecting caregivers to navigate these intricacies without targeted clinical education places an unfair burden on the employee and exposes the patient and the agency to significant risk. By prioritizing advanced stroke education, agencies and facilities do more than just improve compliance; they foster a culture of clinical excellence. The results are undeniable: safer patients, more confident and loyal caregivers, and a highly respected agency brand that stands out as a leader in complex home-based care. For in-depth education on caring for a person with a stroke, contact Kenyon HomeCare Consulting, which offers an 8-hour DSHS-certified continuing education course . Each chronic disease course includes a certification with a red-and-yellow flag guide that can be laminated for caregiving staff. To learn more, call 206-721-5091 or email gkenyon@kenyonhcc.com .
MS care
By Ginny Kenyon August 8, 2026
MS is notorious for its volatility. Understanding nuances like the MS Hug or Uthoff's phenomenon are crucial to providing the quality of care these patient's need.
arthritis care
By Ginny Kenyon August 5, 2026
Arthritis can cause daily pain taking a massive toll on patients, often leading to depression and anxiety. Education bridges the gap between frustration and empathy.
Depression patient
By Ginny Kenyon July 30, 2026
Educating staff on depression isn't just a treating mental health issue—it is actively preventing a cascade of physical declines and re-hospitalizations.
Dementia care
By Ginny Kenyon July 27, 2026
Without proper training, caregivers are thrust into a complex role with no map. Providing structured education is not a luxury, it's a critical intervention.
COPD education
By Ginny Kenyon July 25, 2026
COPD represent a highly vulnerable population. Every field staff member plays a critical role in keeping these patients safe, comfortable, and out of the hospital.
blood sugar
By Ginny Kenyon July 21, 2026
In the caregiving profession, the difference between proactive care and reactive crisis management is education because diabetes impacts almost every body system.
CHF
By Ginny Kenyon July 17, 2026
Chronic disease management can be intimidating for staff, particularly for aides or newer clinicians who may feel unequipped to handle complex cardiac patients.
fixit
By Ginny Kenyon July 14, 2026
Without specific training on how these illnesses behave, caregivers are flying blind, unable to spot subtle warning signs that separate stability from an emergency.