WEST SAINT PAUL, MN - Federal inspectors cited Southview Acres Healthcare Center for multiple privacy violations after discovering wound care being performed with a resident's door wide open and sensitive patient information left unattended where construction workers could access it.
Wound Care Performed in Public View
During the January 9, 2025 inspection, surveyors observed a resident receiving wound care treatment with her room door completely open to the public hallway. Two staff members were changing dressings on the resident's leg wound while red-colored tissue and associated bodily drainage was exposed and visible from the hallway.
When the resident noticed the inspector watching from the hallway, she asked aloud, "What's he doing out there?" The staff members acknowledged the observer but made no attempt to close the door or provide privacy screening during the medical procedure.
The facility's director of nursing approached and questioned why the door remained open during such intimate care. When asked if it could be closed, staff responded that "She wants it open," referring to the resident's preference to keep her door open due to claustrophobia.
Missing Privacy Protections
The resident's care plan documented her request to keep the door open at all times except during brief changes, noting she felt claustrophobic with the door closed. However, the facility failed to explore or document alternative privacy solutions that could accommodate both the resident's claustrophobia and maintain appropriate privacy during medical procedures.
The room contained ceiling-mounted tracks designed for privacy curtains, but no curtains were installed. During interviews, staff acknowledged several potential solutions existed, including portable privacy screens, repositioning mobile equipment carts to block the doorway, or partially closing the door during certain procedures.
The registered nurse manager admitted the facility had portable privacy screens available but questioned how they would be stored or cleaned. Staff also noted that "turning the mobile cart to cover the door would be good" and called it "a very easy option" that hadn't been implemented.
Patient Records Exposed to Contractors
Inspectors discovered a second privacy violation when a medication cart containing detailed patient information was left unattended in a hallway where six construction workers were installing flooring. The care sheet contained names, room numbers, personal preferences, and assistance needs for 25 residents.
The facility administrator immediately recognized the violation, stating "this should not be visible. This is private information" and covered the documents. Multiple nursing staff confirmed that patient information should never be left unattended where unauthorized individuals could access it.
Pressure Ulcer Care Concerns
The inspection also revealed deficiencies in pressure ulcer prevention and treatment. One resident reported having a pressure ulcer that was "going to get worse because the area was not covered with a dressing," with staff only applying cream to the wound.
The resident expressed concern about inadequate repositioning, stating staff were supposed to turn him every two hours but failed to do so consistently. He also reported waiting over an hour for assistance with incontinence care after returning from a medical appointment.
Privacy Standards and Medical Ethics
Healthcare facilities must balance resident preferences with privacy protection requirements under federal HIPAA regulations and Medicare standards. While accommodating claustrophobia is important for patient comfort and mental health, facilities are required to implement creative solutions that protect dignity during medical procedures.
Wound care procedures involving exposed tissue and bodily fluids require particular attention to privacy, as visual exposure can be distressing to other residents, visitors, and staff. Industry standards recommend using portable screens, strategic positioning of equipment, or partial door closure when full closure isn't possible.
The exposure of detailed patient information to unauthorized contractors represents a serious HIPAA violation that could result in identity theft, discrimination, or other privacy harms. Construction areas require heightened security measures for any medical information present.
Facility Response and Correction Requirements
Federal regulations require nursing homes to develop comprehensive care plans that address individual resident needs while maintaining safety and privacy standards. Facilities must document all attempted interventions and alternative approaches when standard privacy measures cannot be implemented.
The nursing staff acknowledged that privacy during medical care represents "a dignity issue for all involved" and confirmed that documentation of offered privacy alternatives should have been included in the medical record.
Southview Acres Healthcare Center must submit a correction plan addressing staff training on privacy protection, implementation of alternative privacy measures for residents with special needs, and protocols for securing patient information during construction or maintenance activities.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Southview Acres Healthcare Center from 2025-01-09 including all violations, facility responses, and corrective action plans.
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