Failure to Provide Timely Incontinence Care Resulting in Skin Breakdown
Penalty
Summary
A deficiency occurred when a resident with a history of atrial fibrillation, weakness, and parkinsonism, who was cognitively intact and required maximal assistance with activities of daily living, did not receive timely incontinence care. The resident's care plan indicated the need for assistance with toileting as needed due to bowel incontinence related to mobility. Despite this, the resident reported sitting in his own bowel movement for hours, resulting in two areas of skin breakdown on his buttocks, later diagnosed as irritant dermatitis due to body fluid. Direct observation confirmed that the resident activated his call light after a bowel movement and waited over an hour for assistance, during which time a CNA was observed using a cell phone and wearing an ear bud. The CNA stated she was delayed due to caring for other residents and was unaware of the expected response time. The DON later confirmed that the acceptable response time was 10 minutes and acknowledged the delay and the presence of scabbed areas on the resident's buttocks. Facility policy required all staff to respond promptly to call lights, but this was not followed in this instance.