SMP Health St Raphael: Food Safety Violations - ND
The September incident at SMP Health - St Raphael illustrates how basic infection control failures can turn routine medical care into a pathway for spreading disease throughout a nursing facility.
Federal inspectors documented two separate violations during their September 24 complaint investigation. Both cases involved staff members who ignored fundamental hygiene protocols designed to prevent cross-contamination between dirty and clean surfaces.
The wound care violation occurred on September 23 at 9:39 a.m. when Nurse #1 entered Resident #73's room wearing the required protective equipment — gown and gloves. She removed a soiled abdominal pad from the resident's left hip, an action that contaminated her gloves with wound drainage and bacteria.
Without changing gloves or washing hands, the nurse immediately began the clean portion of the procedure. She applied wound cleanser to the area, placed a new abdominal pad, and secured it with tape. Only after completing the entire dressing change did she remove her protective equipment and wash her hands.
The contaminated gloves that touched the soiled dressing also handled the clean supplies, creating a direct pathway for bacteria to spread from the infected wound to sterile medical materials.
A more extensive violation occurred that same afternoon during personal care for Resident #16. Two certified nursing assistants, CNA #2 and CNA #5, transferred the resident from wheelchair to bed using a mechanical lift while wearing gowns and gloves.
CNA #2 then performed perineal care after the resident had a soft bowel movement, contaminating her gloves with fecal matter. Rather than changing gloves before continuing, she used the same contaminated hands to reach into a container of ointment and apply it to the resident's skin.
The violations escalated from there. Still wearing the same gloves that had cleaned fecal matter, CNA #2 fastened a new brief, pulled up the resident's pants, and opened a drawer to retrieve a bandana that she placed near the resident's mouth.
She continued using the contaminated gloves to plug in a medical pump, tie garbage bags, lower the bed, turn on the television, and remove a pillowcase from the resident's neck pillow. Only after completing all these tasks did she remove the gloves and perform hand hygiene.
The facility's own policies explicitly prohibit such practices. The November 2018 Glove Usage policy states that "once gloves are contaminated, they must be changed before touching clean items or proceeding to perform clean procedure." It requires hand hygiene both before putting on gloves and after removing them.
The September 2023 Hand Hygiene policy identifies hand washing as "an effective method for preventing the spread of pathogens, such as bacteria and viruses, which cause infections." It specifically mandates hand hygiene "after handling contaminated objects" and "before and after handling clean or soiled dressing."
Administrative Nurse #4 confirmed during a September 24 interview that staff should remove gloves and perform hand hygiene after removing soiled dressings and after performing perineal care.
The inspection found that contaminated gloves touched multiple surfaces in both residents' rooms, including medical equipment, furniture, and personal items. In Resident #16's case, the same gloves that cleaned fecal matter ultimately handled a bandana placed near his mouth and touched the television remote and bed controls he would later use.
Federal inspectors classified the violations as having potential for actual harm, noting that failure to follow infection control standards during wound care and perineal care "has the potential to spread infection throughout the facility."
The September 24 complaint inspection examined infection control practices for seven residents and found violations affecting two of them. Both cases involved staff members who understood the facility's hygiene policies but failed to implement them during actual patient care.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Smp Health - St Raphael from 2025-09-24 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: June 20, 2026 · Our methodology
SMP HEALTH - ST RAPHAEL in VALLEY CITY, ND was cited for violations during a health inspection on September 24, 2025.
Federal inspectors documented two separate violations during their September 24 complaint investigation.
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.