Failure to Provide Proper Perineal Care and Hygiene for Dependent Residents
Penalty
Summary
The deficiency involves the facility’s failure to provide adequate perineal care and maintain personal hygiene for dependent residents requiring assistance with ADLs. For one resident with Alzheimer’s disease, respiratory failure, and heart failure, who was cognitively impaired and totally dependent on staff for ADLs, surveyors observed two CNAs performing peri-care. CNA B wiped the resident’s inner thighs with separate cleansing wipes but then used a single wipe twisted into the front of the genital opening without spreading the surrounding skin folds, and wiped down the leg and up to the anus without separating folds or verifying cleanliness. CNA B later stated they would normally wipe all areas exposed to urine or feces but did not do so in this instance. Other staff, including another CNA, the ADON, DON, and the Administrator, stated that proper peri-care requires cleaning all areas where urine or stool could touch and providing privacy, and an anonymous employee reported that CNA B did not provide good peri-care to two residents who required toileting and changing. For another resident who was cognitively intact but dependent on staff for personal hygiene and had diagnoses including irritant contact dermatitis due to friction or contact with body fluids, UTI, neuromuscular dysfunction of the bladder, and a suprapubic catheter, the ADON was observed providing peri-care after wound treatment. The ADON cleaned the perineal area by wiping once down the middle, then folded the same wipe and used it again down the middle of the perineal area, contrary to facility expectations. In an interview, the ADON stated that a cleansing wipe could be folded and reused up to three times during peri-care, while a CNA, the Administrator, and the DON each stated that a cleansing wipe should only be used once and should not be folded and reused. These observations and interviews showed that staff did not consistently follow the facility’s perineal care policy, which required thorough cleansing of all areas where urine or feces could contact the skin, use of separate wipes for each stroke, and proper technique to maintain hygiene and assess for skin breakdown.
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.