Failure to Provide Timely Incontinence Care and Toileting Assistance
Penalty
Summary
The deficiency involves the facility’s failure to provide timely incontinence care and toileting assistance to residents who were cognitively impaired and dependent on staff for these activities of daily living. One resident’s assessment showed cognitive impairment and dependence on staff for toileting and incontinence care. A private caregiver reported that staff did not toilet or change this resident’s brief unless prompted and that the resident would sit in the same brief for hours. On the survey day, the resident’s brief was last changed around 7:00 AM before being dressed and taken to breakfast. The resident remained in common areas and then in her room for several hours, during which time the private caregiver stated no staff offered toileting or incontinence care. When the resident was finally transferred to bed at 12:37 PM, staff confirmed the brief had not been changed since 7:00 AM, the resident was incontinent of urine, and her buttocks were red. Another resident’s assessment showed severe cognitive impairment, dependence on staff for toileting and incontinence care, and incontinence of stool and urine. The resident’s care plan directed staff to check the resident every two hours and assist with toileting as needed. On the survey day, the resident was observed seated in a wheelchair with an odor of stool in the room. A CNA stated the resident’s brief had last been changed by night staff sometime before 5:00 AM and that the resident was already up and dressed at the start of the CNA’s shift. When CNAs transferred the resident to bed and removed the brief, the resident was found incontinent of a large amount of liquid stool, and the buttocks appeared bright pink. The DON later stated that residents requiring assistance with toileting and/or incontinence care are to receive such care every two hours and as needed, and the facility’s incontinence policy indicated that all incontinent residents will receive appropriate treatment and services based on their comprehensive assessment.
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