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F0677
D

Incomplete Incontinence Care Provided to Resident with Quadriplegia

Pleasant Hill, Iowa Survey Completed on 07-03-2025

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 occurred when a Certified Nursing Assistant (CNA) failed to provide complete and appropriate incontinence care to a resident with quadriplegia, severe cognitive impairment, and bowel incontinence. During observed care, the CNA performed hand hygiene, donned gloves, and used wipes to clean the resident's buttock and front perineal area, wiping from front to back. However, the CNA did not cleanse the resident's right and left hips, which was required by the facility's perineal care policy. The resident's care plan specifically directed staff to assist with perineal cleansing and to observe the skin daily for irritation and redness. Staff interviews confirmed that thigh areas should be cleansed during incontinence care, and policy review indicated that care should extend outward to the thighs.

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