Failure to Accommodate Resident Needs: Stoma Supplies and Television Access
Penalty
Summary
The facility failed to reasonably accommodate the needs and preferences of two residents, specifically regarding timely access to appropriate stoma supplies and the availability of a working television. For one resident with a urostomy due to a malignant neoplasm of the urinary organs and severe cognitive impairment, there were repeated issues with the availability and appropriateness of urostomy pouches. The resident's care plan required specific stoma care and monitoring, but staff and family reported that the correct supplies were not consistently available. The facility initially provided generic pouches that did not function properly, leading to leakage and distress for the resident. Staff interviews revealed miscommunication and delays in ordering the correct supplies, with insurance approval and administrative turnover contributing to the problem. The resident's family had to supply pouches upon admission and expressed frustration over the lack of communication and continuity of care. Observations confirmed that the resident's urostomy pouch was frequently overfilled, contrary to manufacturer instructions that it should be emptied when one-third to one-half full. Staff acknowledged that when the pouch was not emptied in a timely manner, the resident would manipulate it, causing further leakage. Documentation and interviews indicated that the facility was aware of the issue for several weeks before the correct supplies were consistently ordered and available. The resident's daughter reported that she was not informed when supplies ran out and had to instruct staff on proper pouch application, as improper technique led to excessive use of supplies and further complications. For another resident with severe cognitive impairment and multiple chronic conditions, the facility failed to ensure the availability of a working television after the resident was temporarily relocated due to a water pipe break. The resident, who preferred watching television as a primary activity, was moved to a room without a functioning television, and there was no documentation in the medical record regarding the move or the lack of television. The administrator confirmed the absence of documentation and the non-functioning television during the survey. These failures affected the residents' ability to have their needs and preferences accommodated as required.