Inadequate Supply of Incontinence, Catheter, and Custodial Products
Penalty
Summary
The deficiency involves the facility’s failure to maintain adequate supplies of incontinence products, urinary catheter components, and custodial items necessary for trash removal, resulting in care that did not align with physician orders or residents’ preferences and goals. A complaint to the State Agency reported limited supplies of briefs, wipes, chucks, panty liners, and trash bags. Multiple CNAs reported that the facility was frequently out of correctly sized briefs, liners, chucks, and washcloths, and that staff were directed to use reusable washcloths instead of disposable wipes due to plumbing issues, which led to an extreme shortage of washcloths. Night staff reported having to cut up towels or use paper towels for perineal care when washcloths were unavailable. A resident with urinary incontinence and an amputation below the right knee, cognitively intact and frequently incontinent per the MDS, reported wearing two briefs because the facility had run out of liners, which she preferred to use with a brief to avoid soaking the bed, and described this as not ideal. CNAs confirmed that several residents who were heavy wetters and preferred liners or chucks in addition to briefs were instead placed in two briefs due to the lack of liners and chucks. A facility-wide tour with housekeeping staff showed only 13 washcloths on one hall, none on two other halls, and no clean washcloths ready in laundry, despite the DON later indicating there was an unopened box of washcloths stored on a high shelf in the laundry room that had not been accessed. The facility also failed to maintain adequate urinary catheter supplies and custodial trash supplies. A CNA reported frequent shortages of colostomy supplies and correct urinary catheter components, and documentation showed that when a resident self-removed a Foley catheter, the facility was out of Foley bags, leading staff to use an 18F Foley with a leg bag instead. Another cognitively intact resident with chronic kidney disease, obstructive and reflux uropathy, benign prostatic hyperplasia, and an indwelling urinary catheter stated that there had been times catheter supplies ran out and his scheduled monthly catheter change could not be done, and that requested leg anchor bandages were unavailable. Housekeeping staff reported that the facility had completely run out of trash can liners during the prior week, requiring room trash to be emptied into a large trash without changing liners, leaving rooms with used briefs or wipes odorous due to soiled materials leaking onto unchanged trash liners.
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