Incomplete Incontinent Care Provided to Resident
Penalty
Summary
A deficiency occurred when a certified nursing assistant (CNA) failed to provide complete incontinent care to a male resident with severe cognitive impairment, dementia, and type 2 diabetes. The resident was frequently incontinent of bladder and always incontinent of bowel, requiring substantial assistance with toileting and hygiene. During an observed care episode, the CNA removed the resident's saturated brief, cleaned only the buttocks with wet wipes, and did not clean the perineum or external genitalia before applying a new brief. This action was inconsistent with the resident's care plan, which required routine rounding and thorough cleaning to minimize urinary tract infections. Interviews with staff confirmed that proper incontinent care should include cleaning the entire perineal, genital, and anal areas every two hours and as needed. The CNA acknowledged the omission, and other staff, including the RN, medication aide, and DON, confirmed that incomplete cleaning could lead to skin breakdown and infection. The facility's policy on incontinent care was not provided prior to the survey exit.