Health inspection·November 8, 2023

F 0690 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review, policy review, and staff interview, it was determined that the facility failed to assess bladder incontinence and provide services to restore bladder function as much as possible for two of 12 sampled residents. (Residents 7, 16) Findings include: Review of the facility policy entitled, Incontinence - Assessment and Management, last reviewed August 14, 2023, revealed that facility staff was to complete a urinary incontinence assessment upon admission and whenever there was a change in a resident's urinary tract function. Staff would complete a quarterly screening and if there was a change in incontinence staff would implement a seven day toileting diary to determine a resident's voiding pattern for assistance in decision making and development of a toileting program. The type of urinary incontinence was to be identified in the care plan with specific interventions. Clinical record review revealed that Resident 7 was admitted to the facility on [DATE], with diagnoses that included parkinsonism and depression. A Bowel and Bladder Program Screener was completed on April 30, 2023, and indicated that the resident was a candidate for a scheduled toileting program. According to the Minimum Data Set (MDS) assessment, dated July 18, 2023, the resident needed assistance from staff for toileting. The assessment further indicated that the resident was incontinent of urine and was not on a toileting program. Review of the current care plan revealed that Resident 7's type of urinary incontinence was not identified and there was no indication that the resident was on a scheduled toileting program. Review of the MDS assessment, dated October 12, 2023, indicated that Resident 7 was incontinent of urine and was not on a scheduled toileting program. There was no documentation in the clinical record to support that the resident's urinary incontinence was assessed by the facility upon admission and upon a change in Resident 7's incontinence to determine if normal bladder function could be restored. There was no documented evidence that a seven day toileting diary was completed upon identification of a change in Resident 7's incontinence status or that a scheduled toileting program had been implemented. Clinical record review revealed that Resident 16 was admitted to the facility with diagnoses that included congestive heart failure and depression. A Bowel and Bladder Program Screener was completed on October 5, 2023, and indicated that the resident was a candidate for a scheduled toileting program. According to the MDS assessment, dated October 12, 2023, the resident needed assistance from staff for toileting, was frequently incontinent of urine, and was not on a toileting program. Review of the current care plan revealed that Resident 16's type of urinary incontinence was not identified and there was no indication that the resident was on a scheduled toileting program. There was no Page 1 of 2 395927 395927 11/08/2023 Stoneridge Poplar Run 450 East Lincoln Avenue Myerstown, PA 17067

F 0690 documented evidence that a scheduled toileting program had been implemented. Level of Harm - Minimal harm or potential for actual harm In an interview on November 8, 2023, at 12:45 p.m., the Assistant Nursing Home Administrator confirmed that there was no documented evidence that Resident 7's urinary incontinence had been assessed per facility policy or that toileting programs were implemented for Residents 7 and 16. Residents Affected - Few 28 Pa. Code 211.12(d)(1)(5) Nursing services. 395927 Page 2 of 2