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F0550
D

Failure to Maintain Resident Dignity and Provide Timely Incontinence Care

Franklin, Pennsylvania Survey Completed on 11-13-2025

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 maintain resident dignity and provide appropriate incontinence care for one resident with spastic hemiplegia, depression, and anxiety, who required assistance with personal care. According to the resident's care plan, staff were to clean the peri-area with each incontinence episode and provide incontinence products to promote skin integrity and dignity. However, observations revealed that the resident remained in a wheelchair from 6:30 a.m. until 1:45 p.m. without being checked, changed, or repositioned, despite facility policy requiring checks every two hours. At 1:45 p.m., the resident was found with two incontinence briefs filled with feces overflowing onto clothing and skin, and with extremely reddened peri-area and buttocks. Staff confirmed that the resident had not been checked or changed as required and that the use of two briefs was not in accordance with facility protocol. The Nursing Home Administrator also acknowledged that placing two briefs on a resident was not facility policy and that the resident's dignity was not maintained. The failure to provide timely incontinence care and proper use of incontinence products resulted in soiled clothing, skin irritation, and a lack of dignity for the resident.

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