Failure to Assess and Implement Individualized Bowel Continence Interventions
Penalty
Summary
The facility failed to assess and implement individualized interventions to promote bowel continence for a resident whose continence status declined over time. Clinical record review showed that the resident was initially assessed as continent of bowel, but subsequent Minimum Data Set (MDS) assessments documented a decline to occasional and then frequent bowel incontinence. Despite this change, there was no evidence that staff reviewed the resident's bowel and bladder observation records to develop or implement specific interventions tailored to the resident's needs. Additionally, the resident's care plan indicated a need for staff assistance with toileting, but documentation revealed inconsistencies in the frequency of toileting assistance offered. Initially, staff were to assist the resident at multiple times throughout the day, but later documentation showed a reduction in these scheduled toileting times. Interviews with facility leadership confirmed the absence of a policy addressing bowel continence, and the findings were reviewed with the Nursing Home Administrator and Director of Nursing.