Failure to Provide Dignified and Respectful Care During Incontinence Episodes
Penalty
Summary
The facility failed to treat a resident with respect and dignity, and did not provide care in a manner that promoted the maintenance or enhancement of her quality of life. On two separate occasions, the resident, who had diagnoses including type 2 diabetes, vascular dementia, and muscle weakness, experienced episodes of bowel incontinence and did not receive appropriate assistance from staff with activities of daily living (ADLs) or with cleaning herself and her environment. The resident required maximum staff assistance for several ADLs, including toileting hygiene, as documented in her care plan and MDS assessment. On one occasion, the resident reported having an episode of bowel incontinence after breakfast, resulting in feces on herself and the bathroom floor. She activated her call light for assistance, but the CNA who responded told her to clean up the mess herself and did not offer help. The resident remained soiled and her bathroom uncleaned for several hours, as confirmed by observations and interviews with the resident, her private sitter, and staff. The resident expressed feelings of humiliation and self-isolation due to the lack of assistance and the way she was treated by staff. On another occasion, the resident contacted her representative for help after staff again refused to assist her following an episode of incontinence. The representative arrived to find the resident still unattended and had to request staff intervention. Even then, staff only handed the resident towels from outside the bathroom rather than providing direct assistance. Facility policies and staff interviews confirmed that nursing staff were responsible for cleaning biological waste and assisting residents with ADLs, but these expectations were not met in the resident's care.