Based on a review of clinical records, observations, and staff interviews, it was determined that the facility failed to follow acceptable infection control practices regarding enhanced barrier precautions (EBP) during observation of a wound and foley catheter (tubing inserted into the bladder to drain urine) for one of 19 residents reviewed (Resident R78). Findings include: No facility policy on EBP provided. Resident R78's clinical record revealed an admission date of 11/08/24, with diagnoses that included chronic obstructive pulmonary disease (a lung disease that makes it difficult to breathe), anemia (low red blood cells in the blood which carries oxygen), hyperlipidemia (high levels of fats-cholesterol and triglycerides in the blood), and dementia (a disease affecting mood, behavior and decision making). Observation of a wound dressing change on 12/11/24, at 10:30 a.m. revealed that Registered Nurse (RN) Employee E1 and Nursing Assistant (NA) Employee E2 failed to don (put on) proper personal protective equipment (PPE) by not wearing a gown during the dressing change of Resident R78's sacral wound. During an interview with RN Employee E1 on 12/12/24, at approximately 1:00 p.m. it was confirmed that a gown should have been worn as part of EBP during the dressing change for Resident R78's sacral wound. Observation of Resident R78's room revealed that there was no signage alerting persons entering the room of EBP for infection control and no PPE available outside of the room for use. During an interview on 12/11/24, at approximately 2:20 p.m. the Director of Nursing (DON) confirmed that the facility had nine residents with foley catheters, two residents with a feeding tube, two residents with a colostomy, seven residents with a wound, and two residents with a dialysis catheter, but did not have EBP maintained for these residents. The DON further confirmed that employees should be wearing gloves and gowns when providing care for these residents. 28 Pa. Code 211.10(c) Resident care policies 28 Pa. Code 211.12(d)(1)(5) Nursing services