Failure to Initiate Bowel and Bladder Retraining Program for Eligible Resident
Penalty
Summary
A deficiency occurred when the facility failed to implement a bowel and bladder retraining program for a resident who was identified as a candidate for such intervention. The resident, who was admitted with diagnoses including anxiety disorder, bipolar disorder, neuropathy, and psychosis, was found to have intact cognitive functioning and the capacity to make decisions. Despite being always incontinent of bowel and bladder and dependent on staff for lower body dressing and transfers, the resident's assessment and screening indicated eligibility for a retraining program. Interviews with facility staff, including the MDS Coordinator and the DON, confirmed that the retraining program was not initiated as required by facility policy and clinical guidelines. The facility's policy specified that staff should screen for and manage urinary incontinence, provide appropriate services to restore or improve bladder function, and document toileting trials. The failure to initiate the retraining program was acknowledged by staff and was not in accordance with the facility's established procedures.