Failure to Implement Bowel and Bladder Retraining Programs for Eligible Residents
Penalty
Summary
The facility failed to provide appropriate bowel and bladder retraining or toileting programs for two residents who were identified as good candidates for such interventions. Both residents had documented episodes of incontinence and were assessed as being able to communicate their needs and benefit from retraining programs. Despite this, neither resident was enrolled in a bowel and bladder retraining program, and staff interviews confirmed that these services were not implemented. For one resident, medical records indicated a history of urinary tract infection, acute cystitis, and mental health conditions, with assessments showing the resident required substantial assistance with toileting and was always incontinent. Staff interviews revealed that the resident could express the need to use the bathroom but was not included in any retraining program, despite a screener indicating suitability for such intervention. Nursing staff were unable to provide a reason for the lack of program implementation. The second resident had diagnoses including hemiplegia, diabetes mellitus, and cirrhosis of the liver, and was also able to communicate needs despite cognitive impairment. This resident experienced episodes of incontinence, expressed a dislike for wearing diapers, and was similarly identified as a good candidate for retraining. However, the retraining program was not initiated, and staff acknowledged that the process was missed. Facility policy required that residents who are incontinent receive services to attain or maintain continence unless clinically inappropriate, but this was not followed for these two residents.