Failure to Follow Bowel Care Standards and Notify Physician After Prolonged Absence of Bowel Movements
Penalty
Summary
The deficiency involves the facility’s failure to follow professional standards of practice for bowel care by not contacting physicians when residents had no bowel movement (BM) for more than 72 hours. One resident with psychosis and dementia had a documented BM on 1/26/26 at 21:59 and not again until 1/30/26 at 21:53, a 96-hour interval. This resident had a physician’s order dated 10/1/25 for Docusate 100 mg orally twice daily for constipation, and the MAR showed it was administered twice daily throughout January 2026. However, there was no documentation in the medical record that the physician was contacted between 1/26/26 and 1/30/26 regarding the absence of a BM for over 72 hours. The MDS RN stated that nursing staff should have contacted the physician after 72 hours without a BM and had not done so. Another resident with atrial fibrillation and high blood pressure had a documented BM on 2/8/26 at 00:29 and not again until 2/12/26 at 15:05, an 87-hour interval. This resident had PRN orders for Milk of Magnesia 30 ml once daily by mouth for constipation, Bisacodyl 10 mg suppository rectally once daily if needed if Milk of Magnesia was not effective, and Docusate 100 mg orally twice daily as needed for constipation. Review of this resident’s medical record on 2/17/26 at 4:03 PM showed no documented administrations of any of the ordered bowel care medications between 2/8/26 and 2/12/26. These findings show that ordered bowel care interventions and physician notification parameters were not implemented or documented as required for two residents.
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