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F0550
D

Failure to Respond Timely to Call Light and Provide Dignified Incontinence Care

Pekin, Illinois Survey Completed on 06-27-2025

Penalty

Fine: $14,015
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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 resident who required one-person assistance for incontinence care was observed lying in bed with a soiled adult brief and gown, with feces present on her legs and stomach. The resident's call light was on, and she reported having waited for over half an hour for assistance to be cleaned and dressed. She stated that she had activated her call light more than two hours earlier to request help getting out of bed and dressed for the day. A CNA entered the room earlier, turned off the call light, and stated she would return, but did not come back to assist the resident. The resident, who had a knee brace and was unable to get up or dress independently, expressed embarrassment about her situation. The facility's policies require prompt response to call lights and emphasize treating residents with dignity and respect. The CNA acknowledged that she was passing meal trays when the resident requested help and did not have time to assist, so she turned off the call light without providing the needed care. The Director of Nursing confirmed that the resident should not have been left in this condition and that the call light should have been answered more quickly.

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