Failure to Provide Required ADL Assistance With Feeding and Incontinence Care
Penalty
Summary
The deficiency involves the facility’s failure to provide necessary assistance with activities of daily living (ADLs), including dining and incontinence care, to residents who were unable to perform these tasks independently. One resident with Parkinson’s disease, dysphagia, and documented self-care and functional mobility deficits had a physician order indicating staff should now feed him and a care plan noting inadequate oral intake with an intervention to provide dining assistance as necessary. Despite this, staff repeatedly delivered meal trays without providing feeding assistance or encouragement. On multiple observed occasions in the dining room, the resident ate only portions of the meal and then stated he was done, with no staff assistance or prompting. During a breakfast observation, a CNA left the resident in bed with dry cereal, juice, and milk and did not assist, later stating the resident did not need help, even though the resident consumed only a small portion and spilled most of the juice. The registered dietician stated there was an order for 1:1 feeding and that the resident should be fed in the dining room, while dietary leadership explained that 1:1 feed orders do not automatically appear on diet tickets and rely on nursing to notify dietary and CNAs. Another resident with dementia, a leg fracture, neuropathy, and hip pain had a care plan documenting bowel incontinence with an intervention to check the resident every two hours. Surveyors observed this resident lying in bed in a gown with a strong bowel odor and multiple cups of red-colored beverages on a bedside table initially positioned a few feet away and later over the bed, with flies flying around her. A CNA reported that the last personal care and change for this resident had been provided several hours earlier in the morning. The same CNA later stated that for residents who do not use the call light, she typically checks them for incontinence care at the beginning of the shift, around breakfast and lunch, and every 2.5 to 3 hours, while the DON stated residents should be checked every two hours and as needed. Facility grievance logs and resident council reports over several months documented multiple concerns regarding ADLs. Facility policies on ADLs and incontinence care state that residents unable to carry out ADLs independently will receive appropriate services to maintain good nutrition, personal hygiene, and incontinence care based on individual needs and service plans.
We Help Long-Term Care Teams Stay Survey-Ready
We process and analyze inspection reports and plan of correction using AI to extract insights and trends so providers can improve care quality and stay ahead of compliance risks.