Failure to Provide Timely and Adequate Incontinence Care
Penalty
Summary
The facility failed to provide timely and adequate incontinence care for two residents who were dependent on staff for toileting and personal hygiene. For one resident with a history of impaired mobility, pneumonia meningitis, ulcerative colitis, and viral hepatitis, observation revealed that a CNA did not follow proper perineal care procedures. The CNA did not retract the foreskin or adequately clean and dry the scrotal area during incontinence care, despite the resident being saturated with urine and having feces present. The CNA admitted to rushing the care due to being late, and this was inconsistent with the facility's policy, which outlines specific steps for thorough cleaning and drying to prevent infection. Another resident, who was frequently incontinent of bowel and bladder and dependent on staff for toileting, reported waiting over an hour for assistance after activating the call light. Staff interviews confirmed that both a nurse and a CNA were aware of the resident's need for toileting assistance but prioritized other tasks, resulting in the resident remaining in soiled clothing for an extended period. The resident expressed frustration and embarrassment about the incident, noting concerns about sensitive skin. These findings demonstrate that the facility did not ensure prompt and adequate incontinence care as required.