Failure to Provide Timely Incontinence Care to Dependent Resident
Penalty
Summary
The deficiency involves the facility’s failure to provide timely incontinence care to a resident who was always incontinent of bowel and had a Foley catheter in place. The resident had diagnoses including unspecified dementia with psychotic disturbance, neuromuscular dysfunction of the bladder, and pneumonitis due to inhalation of food and vomit, and was documented as having impaired cognition and being dependent on staff for ADLs and incontinence care. The care plan directed staff to monitor and document for signs and symptoms of UTI, provide staff intervention for incontinent episodes, and reposition the resident every two hours and as needed due to risk for skin breakdown. On one observed date at 9:59 A.M., the resident was found lying in bed with a strong odor of stool. At 10:30 A.M., a CNA reported that the resident had not been checked since 6:00 A.M., acknowledged that the resident should have been checked every two to three hours, and confirmed the resident had an odor of stool. On another observed date at 8:42 A.M., the resident was again observed lying in bed with a strong odor of stool, and the same CNA confirmed the odor and stated she would change the resident after feeding her breakfast. The facility’s incontinence care policy required proper incontinence care for all incontinent residents to help prevent skin breakdown, the spread of infection, and to promote dignity, but the observed care did not align with these expectations.
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