Failure to Provide Timely Toileting Assistance to Continent Resident
Penalty
Summary
A resident admitted with a history of lumbar spine fusion, UTI, and pelvic fracture was documented as always continent of bowel and bladder and required substantial to maximal assistance for toilet transfers. Despite this, the resident experienced significant delays in receiving toileting assistance, as evidenced by call light logs showing multiple instances of wait times exceeding 20 to 45 minutes. The resident reported having to wait up to an hour for assistance, resulting in episodes of incontinence, and stated that some staff advised her to urinate in her brief if she could not wait. Documentation showed that on several days, the resident was only toileted once, and there were gaps of many hours between toileting events. Staff interviews confirmed awareness of the resident's concerns regarding long call light response times and inappropriate toileting practices, such as being given a bedpan instead of being assisted to the bathroom. The DON acknowledged that the facility's expectation is for call lights to be answered within 5-10 minutes and that it is not standard practice to advise continent residents to urinate in their briefs. The care plan indicated the resident was at risk for infection related to an indwelling catheter, but the resident did not have a catheter at the time of the deficiency. No concern forms were found for the resident, and documentation revealed multiple incontinence episodes and insufficient toileting assistance.