Failure to Accommodate Resident Bathroom Access Due to Locked Adjoining Bathroom
Penalty
Summary
The facility failed to provide reasonable accommodations for the individual needs and preferences of two residents by denying them access to their adjoining bathroom. Staff removed the doorknobs from the bathroom doors, locking the bathroom and requiring the residents to request staff assistance to access the main bathroom in the hallway. This action was taken despite a lack of clear documentation or evidence that either resident was responsible for clogging the toilets, and staff interviews revealed uncertainty about which resident, if any, had caused the issue. Both residents were observed to have their bathroom doors locked and inaccessible without maintenance assistance. One resident had moderate cognitive impairment, was wheelchair-bound, and was dependent on staff for toileting and transfers. The resident's care plan did not document any history of clogging toilets, and there was no evidence in progress notes of such behavior. The resident reported having to use a urinal or hold their bowels until staff could assist them to the main bathroom, sometimes resulting in incontinence. Staff interviews confirmed the resident did not have access to the bathroom in their room and did not know the code to the main bathroom, requiring staff intervention each time toileting was needed. The second resident also had moderate cognitive impairment and required partial to moderate assistance with toileting. Their care plan mentioned a history of behavior problems and clogging the toilet with foreign objects, but there was no documentation of specific incidents. Observations showed the resident's bathroom was also locked, and the resident resorted to urinating in a trash can in their room. Staff interviews indicated a lack of knowledge about the reason for the bathroom's inaccessibility and no awareness of recent clogging incidents. The administrator confirmed that the bathroom was locked due to uncertainty about which resident was responsible for previous clogs and flooding, and both residents were instead provided with bedside commodes and access to the main bathroom only with staff assistance.