Failure to Provide Sufficient Nursing Staff for Timely Toileting Assistance
Penalty
Summary
The facility failed to provide sufficient nursing staff to meet the toileting needs of three residents, as evidenced by clinical record reviews, staff and resident interviews, and facility documentation. The facility's policy and CNA job descriptions require that residents receive assistance with activities of daily living, including toileting, in accordance with their care plans. However, documentation and interviews revealed that residents experienced significant delays in receiving toileting assistance, particularly during night shifts when staffing was especially limited. One resident, with diagnoses including depression, anxiety, and diabetes, reported frequent and prolonged waits for toileting assistance, resulting in episodes of incontinence and extended periods sitting in soiled briefs. Documentation confirmed long intervals between toileting, sometimes exceeding 10 hours, and a lack of evidence that toileting was provided during certain night shifts. Another resident, requiring assistance from two staff members for toileting, described waiting over 30 minutes for help at night, often attempting to self-transfer due to the delay. A third resident, with multiple chronic conditions, also reported frequent delays in toileting assistance and soiling themselves while waiting for staff to respond to call bells. Staff interviews corroborated these accounts, with a registered nurse and a nurse aide both acknowledging inadequate staffing, particularly on night shifts, leading to longer wait times for residents. The Assistant Director of Nursing and the Nursing Home Administrator confirmed the facility's failure to provide sufficient staff to meet residents' toileting needs, as required by state regulations and facility policy.