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F0550
D

Failure to Honor Resident's Preference for Urinal Use

South Gate, California Survey Completed on 07-18-2025

Penalty

No penalty information released
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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 was identified when staff failed to accommodate a resident's preference to use a urinal, resulting in the resident being required to wear and void into an incontinence brief despite being continent. The resident, who was admitted with diagnoses of pleural effusion and pneumonia, was documented as incontinent in the admission nursing assessment, but both the resident and a registered nurse later confirmed that the resident was not incontinent. The care plan noted the resident's preference for a urinal, but this preference was not honored. During interviews, the resident expressed that the use of an incontinence brief prevented him from voiding in a dignified manner, as he was unable to remove the brief independently. Observations confirmed that no urinal was present at the bedside, and a CNA admitted to assuming incontinence without verifying the resident's ability or preference. The facility's policy required staff to honor resident preferences and promote dignity, but this was not followed in the resident's care.

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