Failure to Provide Timely Toileting Assistance for Dependent Resident
Penalty
Summary
The deficiency involves the facility’s failure to provide timely toileting assistance to a resident who was dependent on staff for ADLs. The resident had Parkinson’s disease, dementia, and an ADL self-care deficit due to weakness, requiring staff assistance. On the observed date and time, the resident was found confused, very restless, with his legs partially off the bed, repeatedly stating he needed to stand up and use the bathroom. The surveyor immediately activated the call light and remained with the resident, encouraging him to stay in bed and wait for help. A CNA who was not assigned to the unit entered the room 12 minutes after the call light was activated, turned off the call light, and left to find the assigned CNA. Four minutes later, an RN appeared at the doorway, stated that CNAs were coming, and then left, while the resident continued attempting to get up to use the bathroom. Two CNAs finally entered the room 20 and 22 minutes after the call light was activated to assist the resident to the bathroom, with one CNA stating the resident required two staff for transfers. After toileting, a CNA stated that the goal was to answer call lights within 15 minutes, but that it depended on unit acuity and what was going on. The facility’s Call Light System policy required staff to respond and assist a resident to the bathroom in a timely manner and to notify a supervisor if unable to respond timely due to workload or an emergency.
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