MARSHALLTOWN, IA - A recent health inspection at Southridge Specialty Care revealed multiple violations of infection control protocols, including staff failing to wear proper protective equipment when providing care for residents with medical devices such as catheters and feeding tubes.
Staff Skipped Essential Protective Equipment During Catheter Care
During the May 29, 2025 inspection, surveyors documented that Staff B failed to wear a required protective gown while performing catheter care for Resident #24. The facility's own Enhanced Barrier Precautions policy, updated in March 2024, specifically mandates that healthcare workers must use personal protective equipment (PPE) when caring for residents with indwelling medical devices, including urinary catheters.
The administrator acknowledged on May 15 that Staff B should have worn a gown during Resident #24's catheter care according to the facility's Enhanced Barrier Precautions requirements. This admission came after surveyors observed the protocol violation during their inspection.
Catheter care requires strict infection control measures because urinary tract infections are among the most common healthcare-associated infections in nursing homes. When staff members skip protective equipment during catheter maintenance, they risk transferring bacteria between residents or introducing pathogens that can cause serious urinary tract infections, which in elderly residents can lead to sepsis, kidney infections, and hospitalization.
Gaps in Sterile Technique for Multiple Medical Procedures
The inspection revealed concerning patterns in how staff handled various medical devices and procedures requiring aseptic technique. The facility's policies outline specific requirements for maintaining sterility during critical care activities, yet these protocols were not consistently followed.
For enteral tube feedings, the facility's November 2018 policy requires staff to "wash and dry their hands thoroughly and wear clean gloves" when preparing or administering feedings through gravity bags. Proper aseptic technique during tube feeding preparation prevents bacterial contamination that can cause aspiration pneumonia or gastrointestinal infections in residents who rely on feeding tubes for nutrition.
The tracheostomy care policy, which has not been updated since August 2013, mandates sterile gloves for all aseptic procedures involving tracheostomy tubes. Tracheostomy sites provide direct access to the respiratory system, making infection control critical. Bacterial contamination during tracheostomy care can result in pneumonia, respiratory infections, or life-threatening sepsis in vulnerable residents.
Medical Significance of Infection Control Violations
These violations represent fundamental breakdowns in infection prevention that nursing homes must maintain to protect their medically fragile populations. Elderly nursing home residents typically have weakened immune systems and multiple chronic conditions that make them particularly susceptible to infections.
Enhanced Barrier Precautions exist specifically to prevent the spread of multidrug-resistant organisms in healthcare settings. When staff members fail to wear appropriate PPE during high-contact care activities, they become potential vectors for transmitting dangerous bacteria between residents. This is particularly concerning for residents with invasive medical devices, as these devices bypass the body's natural defense mechanisms against infection.
Additional Issues Identified
The inspection also uncovered problems with the facility's wound care procedures. The October 2010 wound care policy requires specific steps including proper glove use, hand washing between glove changes, and appropriate disposal of contaminated dressings. However, the age of this policy - unchanged for over 14 years - raises questions about whether it reflects current best practices in wound management.
The facility's infection control policies appear fragmented, with some dating back more than a decade while others were recently updated. This inconsistency in policy maintenance can lead to confusion among staff about current expectations and may contribute to the observed compliance failures.
Industry Standards and Required Improvements
Current infection control standards in long-term care facilities emphasize the importance of consistent PPE use, particularly when caring for residents with invasive devices. The Centers for Medicare and Medicaid Services requires nursing homes to maintain infection prevention and control programs that include proper use of standard and transmission-based precautions.
Southridge Specialty Care must ensure all staff members receive updated training on Enhanced Barrier Precautions and demonstrate competency in following these protocols. The facility should also review and update older policies to align with current infection prevention guidelines and ensure consistency across all care procedures.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Southridge Specialty Care from 2025-05-29 including all violations, facility responses, and corrective action plans.
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