Failure to Ensure Proper PPE Use for COVID-19 Precautions
Penalty
Summary
Staff failed to wear appropriate personal protective equipment (PPE) when caring for residents with confirmed or suspected COVID-19 infection. In one instance, a certified nursing assistant was observed providing care to a resident in a shared room where one occupant was COVID-19 positive, but the CNA wore only a surgical mask and did not use a gown, N-95 respirator, or gloves as required. The CNA confirmed awareness of the resident's COVID-19 status and acknowledged that enhanced PPE should have been used due to the exposure risk to other residents in the room. The Infection Control Preventionist also confirmed that only the correct isolation signage should have been posted and that staff were expected to follow contact and droplet isolation protocols. In another instance, two LPNs entered the room of a resident who had tested positive for COVID-19, wearing only surgical masks, gloves, and gowns, but without N-95 respirators or eye protection. The Infection Control Preventionist confirmed that the nurses should have been wearing N-95 masks and either goggles or a face shield when providing care. Facility policy required the use of all recommended COVID-19 PPE, including N-95 masks, eye protection, gloves, and gowns, for residents under observation or transmission-based precautions. These failures were identified during observations and interviews, and the facility's policy was not followed as written.