Failure to Provide Timely Toileting Assistance and Maintain Dignity for Continent Resident
Penalty
Summary
The facility failed to provide appropriate care and services to a resident who was alert, continent of bowel and bladder, and at high risk for pressure ulcer development. Nursing staff did not assist the resident in a timely manner to use the urinal, which was necessary to maintain bladder continence. Instead, the resident was encouraged to use an incontinence brief for staff convenience, as staff were busy with other residents, resulting in the resident being left in soiled conditions and experiencing embarrassment and discomfort. The resident's care plan and Interdisciplinary Team (IDT) assessment were not implemented to address his toileting needs. The resident was not assessed for a toileting program upon admission, and his toileting habits and needs were not discussed with him. Staff did not inquire about his continence status, and he was admitted wearing an incontinence brief, leading to the assumption that he was incontinent. The resident required assistance with holding the urinal and cleaning himself due to his medical condition, but staff only responded to his needs when he specifically requested help, and there was no scheduled toileting program in place. Interviews with staff and review of facility policies confirmed that the resident's continence status was not properly assessed or documented, and a care plan addressing his bowel and bladder needs was not developed. The lack of timely assistance and failure to respect the resident's dignity resulted in the resident feeling humiliated and increased his risk for skin breakdown. Facility policies required continence assessments and individualized care plans, but these were not followed in this case.