Failure to Provide Timely and Appropriate Incontinence and Perineal Care
Penalty
Summary
A deficiency occurred when a resident, admitted with multiple diagnoses including coronary artery disease, congestive heart failure, peripheral vascular disease, morbid obesity, and chronic kidney disease, did not receive timely incontinence care and appropriate perineal hygiene. The resident was care planned for incontinence of bowel and bladder, requiring checks and changes every two hours and as needed, with specific instructions for perineal cleansing and use of moisture barrier. Documentation showed the last incontinence check was at 4:55 A.M., and by 8:14 A.M., the resident reported being soiled and not having been checked since approximately 5:00 A.M. The CNA who assumed care at 6:30 A.M. was unaware of the last incontinence check and had not checked the resident since starting her shift, despite knowing the resident required frequent checks. During observation, two CNAs provided a bed bath and incontinence care but failed to cleanse the resident's perineum after an episode of bowel and urinary incontinence. The resident's brief was found to be heavily soiled, and while the buttocks were cleansed and barrier cream applied, the perineal area was not cleaned according to facility policy. The CNA later confirmed that perineal cleansing was not performed. Facility policies required thorough perineal care to prevent infection, but these were not followed, resulting in non-compliance.