Failure to Honor Continent Resident’s Toileting Needs and Dignity
Penalty
Summary
The deficiency involves the facility’s failure to ensure that a continent resident did not lose the ability to perform activities of daily living, specifically toileting, without a medical reason. The resident was admitted with diagnoses including essential HTN, spinal stenosis, and type 2 DM without complications, and the H&P documented that he had the capacity to understand and make decisions. An MDS assessment showed he required substantial/maximal assistance with sit-to-lying and was dependent for toilet and tub/shower transfers and sit-to-stand, while a bowel and bladder evaluation documented that he was continent. His care plan identified ADL deficits related to spinal stenosis and directed staff to provide two-person assistance with toilet transfers and to encourage him to participate to the fullest extent possible with each interaction. Despite these assessments and care plan directives, the resident was observed wearing an adult brief and reported that staff had placed him in the brief and told him to use the restroom in it. He stated that a nurse told him to urinate in the adult brief instead of using other options such as a bedpan or bedside commode, and he described difficulty urinating and feeling like a baby when made to wear the brief. A CNA reported that she put an adult brief on the resident because he urinated everywhere when using a urinal and stated she puts adult briefs on all her residents unless instructed otherwise. An RN confirmed that the resident was continent and did not need briefs and should be allowed to use a bedside commode if that was his preference. The DSD stated that continent residents should not be made to wear adult briefs and acknowledged that placing diapers on continent residents and telling them to go in them could cause them to lose the urge to control their bladder. The facility’s resident rights policy stated that all residents are to be treated with kindness, dignity, and respect.
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.