Failure to Implement Individualized Continence Care
Penalty
Summary
The facility failed to implement individualized approaches to prevent declines in bowel continency and restore normal bowel function for a resident. The facility's policy requires that residents with potential for improved continence be placed on a retraining program. Upon admission, re-admission, significant changes, or after urinary catheter removal, a bowel and bladder diary should be completed for at least three days to assess the resident's continence status. However, for one resident, who was frequently incontinent of both bowel and bladder, the facility did not evaluate the resident's bowel and bladder habits to develop an individualized toileting retraining program. The resident, admitted with diagnoses including hypertension, anxiety, and recurrent urinary tract infections, required partial/moderate assistance with activities of daily living, including toilet transfer and toileting hygiene. Despite a continence evaluation recommending routine toileting and checks, there was no evidence that the recommended program was implemented. This lack of action led to the deficiency, as the facility did not adhere to its policy of evaluating and implementing a toileting program to manage the resident's incontinence.
Plan Of Correction
1. Resident 65 has started a bowel/bladder diary to evaluate continence and provide a proper training program for bowel/bladder habits. Results of the program have been placed on the cardex and put on the comprehensive care plan. 2. Residents who are identified as having the potential to improve their continence will be placed on a retraining program. Residents will be assessed upon admission, readmission quarterly and annually. 3. The Bowel and bladder policy has been reviewed/revised to assure residents who are identified as having the potential to improve continence are placed on a retraining program. The policy has been in-serviced to licensed and direct care staff. 4. The DON/designee will audit 5 residents (admits, readmits, sig change, annual) to assure that residents that have the potential to improve continence are placed on a retraining program. The audit will be turned in to the QA team for review. 5. February 18, 2025