Failure to Provide Timely Toileting Hygiene for Dependent Resident
Penalty
Summary
The facility failed to provide toileting hygiene at least every two hours and as needed for a resident who was dependent on staff for activities of daily living. The resident, who had severe cognitive impairment, osteoarthritis, muscle weakness, dysphagia, metabolic encephalopathy, and dementia, was care planned to be checked and assisted with toileting every two hours due to incontinence. However, documentation and staff interviews confirmed that the resident was not checked or changed according to this schedule on all shifts. On one occasion, a family member assisted with toileting hygiene and found feces embedded in the vaginal area and urine leaking onto the wheelchair. A CNA confirmed that the resident's adult disposable brief was not checked for nearly three hours, during which time the resident was found soiled with urine and feces. The Assistant Director of Nursing reviewed records and confirmed the lack of timely checks and changes, and the Director of Nursing acknowledged that dependent residents need to be kept clean. The facility's policy required appropriate care and toileting assistance, which was not provided in this case.