Failure to Provide Timely and Appropriate ADL Assistance for Dependent Resident
Penalty
Summary
A dependent resident with diagnoses including major depressive disorder, osteoarthritis, and Alzheimer's disease was not provided with adequate assistance for activities of daily living (ADLs) as required by her care plan. On observation, certified nursing assistants (CNAs) found the resident in bed with both an incontinence pad and an incontinence brief, both saturated with dark urine, and the resident reported being wet. The CNAs were unable to determine when the resident's incontinence brief was last changed, and one CNA stated that the resident should have been gotten up by the night shift earlier in the morning. Facility policy requires that residents unable to perform ADLs receive necessary services to maintain hygiene, and staff interviews confirmed that incontinence care should be provided at least every two hours and that an incontinence pad should not be used together with an incontinence brief. The resident's records indicated she is dependent on staff for toileting and personal hygiene and does not refuse care.