Failure to Provide Timely Bowel Management Interventions
Penalty
Summary
The facility failed to identify and provide appropriate interventions for a resident experiencing constipation and diarrhea. Record review showed that the resident had orders for Miralax and Senna for constipation, which were both reduced or discontinued on 3/19/25, and Imodium was started for diarrhea. Despite these medication changes, the resident had no documented bowel movement for five days (3/25/25-3/29/25). During this period, the bowel regimen had been decreased and an antidiarrheal was administered. The Bisacodyl suppository, ordered as needed, was not documented as given during March 2025. Nursing notes during this time indicated active bowel sounds and noted constipation, but no further interventions were documented. Facility policy required daily monitoring of bowel movements and initiation of a bowel protocol if no bowel activity was noted in 72 hours, with results to be documented in the electronic health record. The surveyor's review found that the resident's lack of bowel movement was not addressed according to protocol, and there was no evidence that the provider was notified or that the bowel protocol was initiated after five days without a bowel movement. The deficiency was confirmed through record review, interviews, and policy review, with no additional information provided by the facility at the time of exit.