Failure to Implement Scheduled Toileting Program for Incontinent Resident
Penalty
Summary
The facility failed to develop and implement a scheduled toileting program for a resident who was frequently incontinent of bowel, despite being assessed as a candidate for such a program. The resident was cognitively intact, able to express needs, and dependent on staff for transfers and toileting hygiene. Documentation showed that the resident was not on a toileting program, and interviews revealed that the resident had not been offered or discussed a scheduled toileting program, even though they expressed interest in trying one and dissatisfaction with using briefs. The resident also reported not having access to a bedside commode and being unable to get to the bathroom independently. Staff interviews indicated that the facility's process for establishing toileting schedules included assessments and tracking bowel patterns to identify candidates for scheduled toileting. However, staff acknowledged that the resident's assessment had not been followed up appropriately, and the resident had not been identified or placed on a toileting program, despite having a documented pattern of large bowel movements during shower transfers. The facility's policy required care and services to restore as much normal bowel function as possible for residents admitted with incontinence, but this was not implemented for the resident in question.