Crittenden County Health & Rehab: Infection Control Failures - KY
The inspection, conducted February 7, 2025, centered on care provided to a resident identified in records as R37, a patient whose condition required enhanced infection control precautions because of an ostomy and open wounds. The nurse, referred to in the report as LPN1, was observed performing wound care on R37. He did not put on a gown before starting, despite knowing the resident required it. He cleaned the wounds but left dried stool behind before applying a treatment and fresh dressing.
When he finished, LPN1 pulled off his gloves, dropped them into a red biohazard bag along with the used ostomy bags, and left the bag open at the resident's bedside. The report noted the bag had a foul odor. He then walked out of the room and went to the nurses' station, then into the medication room. He did not wash his hands at any point.
Interviewed that afternoon at 2:33 PM, LPN1 did not dispute any of it. He acknowledged the handwashing lapse, the missing gown, and the bag of contaminated waste left behind. He told inspectors he understood the stakes. "There are bad outcomes," he said, "from not performing hand hygiene as he could pass bad pathogens back and forth between residents." He knew R37 was on enhanced precautions. He confirmed he skipped the gown anyway.
The facility's infection control nurse, who received her certification in May 2024, told inspectors she had never observed LPN1 perform wound care. She said she was supposed to conduct hand hygiene evaluations twice a week but could not keep up with that because she was also working the floor. She expected all staff to wash their hands, wear required protective equipment, and remove contaminated materials from resident rooms after care. She had no way of knowing whether they were.
That gap between expectation and observation is what the inspection report documents. The Director of Nursing said she expected staff to follow infection control policy and use good hand hygiene. The administrator said the same, adding that soiled ostomy bags and dressings should be removed from the room and a clean bag placed in the trash can. None of them had been watching LPN1 work.
The infection control failures here are not complicated. A nurse who handles contaminated wound dressings and ostomy bags for a patient on enhanced precautions is supposed to wash his hands before touching anything else in the building, including medication. That is not an obscure standard. LPN1 said he knew it. He called his failure to follow it a habit.
A habit is something that happens more than once.
The inspection report covers a single observed incident on a single day. It does not say how many times LPN1 had gone from a contaminated wound to the medication room without stopping to wash his hands. It does not say how many other residents received medications prepared in that room on days when the infection control nurse was too busy on the floor to watch. Those questions are not answered in the report.
What is answered is this: a nurse at Crittenden County Health & Rehabilitation Center told a federal inspector, on the record, that not washing his hands after handling infected wound dressings was a bad habit, that he knew it could spread pathogens between residents, and that he did it anyway.
R37, whose wounds still had dried stool on them when the new dressing went on, remained in a room with an open bag of his own contaminated waste sitting at his bedside.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Crittenden County Health & Rehabilitation Center from 2025-02-07 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: July 5, 2026 · Our methodology
Crittenden County Health & Rehabilitation Center in Marion, KY was cited for violations during a health inspection on February 7, 2025.
The nurse, referred to in the report as LPN1, was observed performing wound care on R37.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.