Westminster Village

residents (R4) reviewed for infection control in the sample of 3.The findings include:R4's Order

inserted central catheter (PICC).

The order had a start date of 3/26/26.On 3/31/26 at 11:12 AM, there was an enhanced barrier precaution sign on R4's bathroom door.

The sign indicated that staff must wear gloves and a gown with device care and use.On 3/31/26 at 11:12 AM, V16 (Registered Nurse) was in R4's room. V16 was handling R4's PICC. V16 had on gloves but no gown. V16 said she was disconnecting R4 from his antibiotic. On 3/31/26 at 12:47 PM, V7 (Infection Control Nurse) said enhanced barrier precautions are precautions to help limit infections. V7 said staff were to wear gloves and a gown when handling a PICC.

The facility's Enhanced Barrier Precautions Protocol policy with a revised date of 7/26/21 showed gloves and gowns were to be used during high contact care activities.

Examples of high contact care activities included device care or use.

Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.

For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.

LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE