Failure to Provide Timely Toileting Assistance to Dependent Resident
Penalty
Summary
A deficiency occurred when staff failed to provide timely toileting assistance to a resident with severe cognitive impairment and a diagnosis of Alzheimer's disease, anxiety disorder, and weakness. The resident was assessed as requiring substantial to maximal assistance for toilet transfers and was dependent on staff for toileting hygiene. The care plan specified that two staff members were needed for toileting. During an observed meal, the resident consumed a significant amount of fluids and verbally expressed the need to use the bathroom. Despite this, one CNA deferred action after another CNA questioned the resident's request, instructing that the resident should only be taken to the bathroom if she repeated her request. The resident was not assisted to the bathroom and remained in the dining room for an extended period. Interviews with staff, including a CNA, an LPN, and the ADON, confirmed that the expectation was to assist the resident to the bathroom upon request. The facility's policy directed staff to toilet residents before and after meals and as needed throughout the day. The failure to respond to the resident's voiced need for toileting assistance was inconsistent with both the resident's care plan and facility policy.