Failure to Provide Timely Incontinence and Nail Care
Penalty
Summary
A deficiency occurred when a resident with mild intellectual disabilities, heart failure, and depression, who required partial to moderate assistance with toileting hygiene, did not receive timely incontinence and nail care as directed by their care plan and facility policy. The resident was observed over a period of several hours without being offered assistance with toileting or incontinence care, despite care plan instructions to check and assist every two hours. The resident was later found with a heavily saturated incontinence brief and urine odor, and staff only provided care after being prompted by the surveyor. Staff interviews confirmed that the resident was not checked or changed as frequently as required, with one CNA stating she was the only one working on the hall and another indicating changes were attempted only before lunch and supper. Additionally, the resident's nails were observed to be untrimmed and had a black substance under several nails on multiple occasions, contrary to the facility's nail care policy requiring nails to be kept clean and trimmed. Despite these observations, no staff were seen addressing the resident's nail hygiene during the survey period. The DON confirmed that staff are expected to check and change residents every two hours and maintain clean, trimmed nails, but these standards were not met for this resident.