Failure to Promptly Respond to Resident’s Repeated Toileting Requests
Penalty
Summary
The deficiency involves staff failing to promptly respond to a resident’s repeated requests for toileting assistance, resulting in unmet needs. The resident had been admitted with traumatic hemorrhage of the cerebrum, muscle weakness, lack of coordination, and had moderately impaired cognition. The resident’s MDS indicated dependence for rolling and chair/bed-to-chair transfers. During an observation period, the resident was seated in a wheelchair at the foot of the bed, facing away from the door, and repeatedly yelled, “Can I go to the bathroom,” a total of 16 times, and also stated, “I would make a mess and you going to be stuck with it.” During this time, CNA 1 entered the room while the resident was calling out but only looked around and left without communicating with or assisting the resident. CNA 2 later entered the room but also did not assist with toileting or communicate with the resident and then left. LVN 1 was observed standing by the medication cart near the resident’s room while the resident continued to call out, and then began preparing medications before entering the room to administer them. Staff interviews confirmed that LVN 1 was preoccupied with the medication pass and that CNA 1 was taking out meal trays and described the resident as very persistent. The facility’s “Resident Rights – Quality of Life” policy stated that demeaning practices and standards of care that compromise dignity are prohibited and that staff are to promote dignity by promptly responding to residents’ requests for toileting assistance.
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