Resident Left on Soiled Bedding Without Timely Care
Penalty
Summary
A resident with diagnoses including diabetes mellitus and psoriasiform dermatitis was observed lying on a bed with a soiled bottom sheet containing dry skin flakes, dark specks, and discoloration spots. The resident reported needing to be changed and stated she had not received care since the previous night. Observations revealed her skin was scaly and shedding from her shoulders, arms, torso, and legs, with a significant amount of dried skin present on the sheet. Certified Nursing Assistants (CNAs) confirmed that care had not been provided to the resident prior to the observation that morning, despite the resident requiring maximum assistance for bathing, hygiene, and bed mobility as documented in her assessment. The electronic medical record indicated the last incontinence check was the previous evening, with no applicable care documented for the early morning hours.