Failure to Reassess and Intervene for Resident with Chronic Constipation
Penalty
Summary
The facility failed to reassess and implement new interventions for a resident with a known history of constipation, despite clear evidence of ongoing issues. The resident, who was cognitively intact and had Parkinson's Disease—a condition commonly associated with constipation—was frequently incontinent of bowel and required significant assistance with toileting. Documentation showed the resident often went several days without a bowel movement, including a period of ten days without one, and had only minimal bowel movements over the course of the month. Although the resident was on scheduled medications for constipation, there was no recent bowel evaluation that assessed her typical patterns, what was normal or abnormal for her, or what interventions had been attempted or were in place to prevent constipation. Progress notes for the relevant period lacked documentation of the resident's constipation or any interventions used to promote bowel movements until after the resident reported constipation and discomfort. Interviews with staff revealed inconsistent practices and expectations regarding bowel movement tracking and intervention, with some staff unsure of what actions were being taken to manage the resident's constipation. The facility was unable to provide a policy on constipation management when requested. These actions and omissions resulted in a failure to provide appropriate treatment and care according to the resident's needs and medical condition.