Failure to Provide Timely Toileting Assistance for Dependent Resident
Penalty
Summary
A deficiency occurred when a resident who required total staff assistance for activities of daily living, including toileting, was not provided timely assistance. The resident, who had a history of heart failure, stroke with paralysis, sepsis, obstructive uropathy, anxiety, depression, and diabetes, was cognitively intact and dependent on staff for bed mobility, transfers, and toileting. The care plan specified that the resident should be checked and changed every two hours when in bed and required two staff members and a full lift for transfers. On the morning in question, the resident activated the call light at 7:15 AM after completing a nebulizer treatment, indicating a need to use the commode for a bowel movement. Although a medication aide entered the room, the resident was not assisted with toileting at that time. The call light was activated multiple times, and staff were aware of the resident's request. Despite repeated requests and activation of the call light, the resident waited a total of 1 hour and 24 minutes before two nurse aides arrived to assist with transfer to the commode. During this time, the resident became incontinent of feces. Staff interviews confirmed that only two direct care staff were working that morning, and the resident was left waiting while staff assisted other residents. The resident's care plan interventions for timely toileting and incontinence management were not followed, resulting in the resident remaining soiled until staff were available to provide assistance.