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F0690
D

Improper Perineal Care Technique During Incontinent Care

Orange, Texas Survey Completed on 04-25-2025

Penalty

Fine: $155,060
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

A deficiency occurred when a certified nursing assistant (CNA) failed to provide appropriate perineal care to a female resident who was always incontinent of bowel and bladder and had a recent urinary tract infection. During observed incontinent care, the CNA cleaned the resident's perineal area by wiping towards the rectum, but then cleaned the rectal area and wiped towards the vaginal area once, contrary to proper infection control procedures. The resident's care plan required extensive assistance for personal hygiene and noted she was receiving antibiotics for a urinary tract infection at the time of the incident. The CNA acknowledged during an interview that she had been trained to wipe from clean to dirty and recognized she should have wiped from front to back. The Director of Nursing confirmed that the facility's policy and expectations were for staff to wipe from front to back to prevent infections. The facility's written procedure also specified cleaning from front to back using a separate section of the wipe for each stroke.

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