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Cleaning and Disinfecting Glucose Meters Shared Between Residents

PDF Version of DQA 09-054  (PDF, 42 KB)

Date: December 11, 2009
To: Nursing Homes NH 28
From: Paul H. Peshek, Director
Bureau of Nursing Home Resident Care

Otis Woods, Administrator
Division of Quality Assurance

The Bureau of Nursing Home Resident Care within the Division of Quality Assurance (DQA) is an agent of the federal government and conducts nursing home surveys to ensure compliance with federal health and Life Safety Code regulations. Satisfactory performance during these surveys is required for facilities to continue their participation in the Medicare and/or Medicaid programs.

The purpose of this memorandum is to provide information and guidance regarding the cleaning and disinfecting of glucose meters that are shared between residents in the facility. 

This memo is to notify you that effective immediately, the revised guidance at F441, issued by the Centers for Medicare and Medicaid Services (CMS) on 11/30/09, directs surveyors to cite at the level of immediate jeopardy the deficient practice of failing to clean and disinfect the shared glucose meter between residents. 

Not cleaning and disinfecting a glucose meter that is shared between residents after each resident use may result in serious outcomes because of the potential for transmitting blood-borne pathogens, even if blood is not readily visible. (See page 36 of the revised guidance for F441 at the end of this memo.)

In a memo dated May 6, 2008 (DQA memo 08-13), we noted, "The Division of Quality Assurance (DQA) has observed instances in facilities where facility staff have not adhered to the standards of practice to prevent patient-to-patient transmission of blood borne pathogens when using glucose meters.

Patient-to-patient transmission of blood borne pathogens is a well known risk when lancets, needles, and syringes are reused between patients. However, patient to patient transmission of pathogens facilitated through the use of devices such as glucose meters may not be as well known." 

As part of the directions given in that memo, we noted, "Glucose meters should be assigned to individual patients. If glucose meters are shared between patients, the devices should be cleaned and disinfected between each patient use." (Emphasis added.) (

Please review your policies and procedures and share this information with all staff in your facility that may use glucose meters and/or supervise and train those who use glucose meters. 

While CMS regulation F441 has been in place for several years, this memo constitutes official notice that a violation involving the failure to clean and disinfect shared glucose meters between resident use will have serious consequences. No grace period is in effect for this requirement, so you are asked to act upon this information immediately.

Thank you for your immediate attention to this situation. If you have questions, please contact your Regional Field Operations Director (RFOD) at the location and phone number below.

Southern Regional Office - Pat Virnig, Interim RFOD (608) 266-8886
Southeastern Regional Office - Jean Rucker, RFOD (414) 227-4563
Northeastern Regional Office - Dolores Zwiers, Interim RFOD
(920) 983-3185
Northern Regional Office - Jessica Radtke, Interim RFOD 
(715) 365-2801
Western Regional Office - Kathy Lyons, Interim RFOD
(715) 836-3030

Revised Guidance for F441 (PDF, 251 KB)

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