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F0684
D

Failure to Provide Properly Sized Incontinence Briefs Resulting in Skin Irritation

La Grange, Illinois Survey Completed on 09-24-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to provide appropriately sized incontinence briefs to a resident, resulting in skin irritation and excoriation. The resident repeatedly expressed discomfort with the green incontinence briefs, stating they were too small and caused pain and redness in the perineal and groin areas. Multiple CNAs confirmed that the green briefs did not fit the resident properly and that she preferred the larger, white bariatric briefs, which were not provided because she was not on the supply list for that size. Staff reported that brief sizing was determined by a list based on weight, not on individual body measurements or resident preference, and that requests to central supply for the larger size were denied due to the resident not being on the approved list. The central supply manager and nursing staff indicated that only certain residents were assigned the larger, more expensive briefs, and the resident in question was not included despite staff notifications of her needs. The wound care nurse was unaware of the resident's skin breakdown, and the DON acknowledged that the resident had a pear-shaped body and irritation in the groin area but stated that girth measurements were only taken for residents over a certain weight. The resident's medical record showed significant physical impairments and a need for substantial assistance with hygiene. Facility policy stated that resident preferences should be accommodated unless health or safety would be endangered.

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