Failure to Implement Scheduled Toileting Interventions
Penalty
Summary
A deficiency was identified when the facility failed to implement scheduled toileting interventions for a resident as indicated in the resident's care plan. The resident, who had diagnoses including chronic kidney disease, hypertension, post-surgical pain, impaired mobility, and post lumbar spinal decompression, was prescribed diuretic medications that increase urine production. The care plan specified that toileting should be offered every two hours to address the resident's genitourinary needs. Record review showed that from the time of admission through several days, documentation indicated the resident was incontinent, but there was no evidence that two-hourly toileting was offered as required by the care plan. The DON confirmed that there was no documentation to show the intervention was provided and acknowledged that the facility's practice of charting by exception made it impossible to verify if the care plan was followed. Facility policies reviewed also required assessment and implementation of measures to prevent and reduce incontinence, including scheduled toileting.