Failure to Provide Timely Incontinent Care
Penalty
Summary
The facility failed to provide timely incontinent care for a resident who was frequently incontinent of bladder and dependent on staff for toileting. According to the resident's Minimum Data Set (MDS), the resident required assistance with toileting and was frequently incontinent. On the morning of the observation, the resident was found in bed with a soaked incontinence brief containing dark yellow/light brown urine, and their hair was disheveled. The staff member assigned as the resident's morning aide confirmed that incontinent care had not been provided since the aide's arrival at 7:00 a.m., as other duties such as passing breakfast trays and preparing residents for the hair salon took precedence. The aide was unsure when the night shift last provided care. A review of the resident's care documentation indicated that the last recorded incontinent episode was at 1:08 a.m., with toileting hygiene marked as not applicable at that time. The Director of Nursing confirmed that the resident did not receive timely incontinent care. The facility's policy requires staff to appropriately manage urinary incontinence and provide services to prevent urinary tract infections, but these procedures were not followed for this resident.