Failure to Provide Timely Assistance with ADLs and Incontinence Care
Penalty
Summary
Surveyors identified multiple instances where staff failed to provide appropriate assistance with activities of daily living (ADLs), including toileting and personal hygiene, for several residents. One resident was observed to be disheveled, with soiled clothing and bedding, and reported not having received a shower as scheduled. Documentation did not reflect that the resident had refused care, and staff interviews confirmed that required hygiene and linen changes had not been performed. The resident's care plan indicated a need for staff assistance with bathing and dressing, but these interventions were not consistently implemented. Another resident was found lying in bed with visibly soaked clothing and bedding, and a strong urine odor was present in the hallway outside the room. The resident stated they had not been changed since the previous night, and documentation for incontinence care was missing for the overnight shift. Staff interviews revealed that the resident was dependent on staff for toileting and incontinence care, which should have been provided every two hours and before meals, but was not done. The care plan for this resident also required extensive staff assistance for toileting, which was not followed. Additional deficiencies were observed with other residents, including one who was found soaked with urine because the assigned CNA was attending to other residents and did not have time to provide incontinence care before breakfast. Another resident, who was totally dependent on staff for toileting, was left waiting for assistance after requesting help, as the CNA did not return to provide the needed care. The facility's policy required that residents unable to perform ADLs independently receive necessary services to maintain hygiene and dignity, but these procedures were not followed, as evidenced by the observations and staff interviews.