Crittenden County Health & Rehabilitation Center

F-F684.) However, LPN1 did not clean all of the dried stool from the wounds before

he applied a treatment and dressing. After the procedures were completed, LPN 1 removed his gloves, placed them in a red bag along with the contaminated ostomy bags, and left the open red bag, which had a foul odor at the resident's bedside. LPN1 proceeded to leave the room and go to the nurses' station. He did not perform hand hygiene before he then went into the medication room.

During an interview with LPN1 on 02/07/2025 at 2:33 PM, he stated he had a bad habit of not washing his hands. LPN1 added that, There are bad outcomes, from not performing hand hygiene as he could pass bad pathogens back and forth between residents. LPN1 also stated he was aware that Resident R37 was on enhanced barriers due to his ostomy and wounds; however, he confirmed that he failed to put on a gown prior to providing care. He also stated he should have tied up the red bagged contaminated dressing and removed it from the resident's room.

During an interview with the Infection Control (IC) Nurse on 02/06/2024 at 3:10 PM, she stated she received her IC certificate in 05/2024. She stated she had not watched LPN1 do wound care. The IC Nurse added that

she is supposed to do hand hygiene evaluations two times a week. However, the IC Nurse continued, she could not currently watch all staff for hand hygiene practices as she is working the floor. She stated she expected LPN1, and all staff, to use good hand hygiene practices, use the required personal protective equipment including gowns, and remove all contaminated trash from the room after care, per infection control policy.

An interview with the Director of Nursing (DON), on 02/07/2025 at 2:58 PM, revealed her expectation was for nursing staff to follow the infection control policy as written, use good hand hygiene, and use the personal protective equipment provided.

During an interview with the Administrator on 02/07/2025 at 3:30 PM, she stated she expected all nursing staff to follow facility policies regarding good infection control practices, which included hand hygiene and removing soiled ostomy bags and dressing. She stated she expected staff to remove the soiled items from

the room and replace a clean bag to the trash can.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 7 of 7 185269

F-F880).

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

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 1 of 7 185269 Department of Health & Human Services Printed: 09/09/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 185269 B. Wing 02/07/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Crittenden County Health & Rehabilitation Center 201 Watson Street Marion, KY 42064

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.

(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0656 During an interview with LPN1 on 02/07/2025 at 2:33 PM, he stated he did not take the time to put on a gown (as an EBP) prior to providing care; however, he continued, he should have taken the time. LPN1 stated the Level of Harm - Minimal harm or Comprehensive Care Plan was used to tell everyone how to care for all the resident sand confirmed he was potential for actual harm not following the care plan as written.

Residents Affected - Few B. Review of the Comprehensive Care Plan, dated 09/04/2024, revealed the resident had a problem of an open area to the left buttock, which was verified by a medical doctor as a chronic fistula wound. Review of

the Comprehensive Care Plan, dated 05/23/2024, revealed the resident also had a problem of an open area to the right buttock. Both care plan problems included a goal to heal skin and prevent infection. Care Plan approaches to meet these goals included for staff to deliver prescribed treatment.

Review of the physician-prescribed treatment orders, dated 02/01/2025, revealed an order for wound care, with a start date of 01/18/2025, which included cleansing the buttock wounds with Dial soap and water, as well as the application of Neosporin ointment (triple antibiotic ointment) 3.5 milligrams, to the wounds.

An observation on 02/06/2025 at 2:40 PM during wound care revealed LPN1 failed to follow the care plan by delivering the prescribed treatment. LPN1 cleansed the resident's wounds with Dakin's solution, instead of with Dial soap and water. Further observation of the treatment revealed LPN1 failed to apply Neosporin ointment, and instead applied a topical lotion (Dermacil).

During an interview with LPN1 on 02/07/2025 at 2:33 PM, he acknowledged that he had not provided the prescribed treatment in accordance with the care plan. (Refer to