Can I Retain a Resident with MRSA?

The incidence of infections from drug-resistant organisms continues to be major problem in the United States. Assisted living and residential care providers are increasingly faced with a resident who is infected or colonized with these organisms, such as methicillin-resistant Staphylococcus Aureus (MRSA) and vancomycin-resitant enterococci (VRE). One of the most important questions for providers is whether or not the infected or colonized resident can be retained in the RCFE.

Community Care Licensing (CCL) provides guidance on this in the RCFE Evaluator Manual which states in part:

“Some bacteria that can cause infection have developed a resistance to certain antibiotics. Among these are methicillin-resistant staphylococcus aureus (MRSA) and vancomycinresistant enterococci (VRE). Antibiotic resitant bacterial infections are most often contracted in hospitals and brought into facilities by patients upon hospitals discharge. The elderly are the at high risk because their health and immune systems are generally less robust that those of younger people.

“If a resident is diagnosed with a methicillin-resistant staphylococcus aureus or vancomycin-resistant enterococci infection, the resident must be relocated elsewhere, such as to an acute care hospital or a skilled nursing facility, until the infection is cleared unless the facility applies for and receives an exception. Regulation Section 87616, Incidental Medical Related Services Exceptions, allows a licensee to submit a written exception request if he/she agrees that the resident has a prohibited health condition but believes that the intent of the law can be met through alternative means.

“Sometimes a resident may be known to be colonized but not infected with an antibioticresistant bacterium. Colonization without infection is not prohibited in facilities, and so no exception is required to retain a resident who is colonized without infection. However, colonized residents can transmit infection to others, and, therefore, universal precautions should be practiced with any resident who is known to be colonized with an antibiotic-resistant bacterium.”

Further information on how to obtain an exception for a resident with an antibiotic-resistant infection can be found in the RCFE Evaluator Manual.

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