Incontinence care refusal in the nursing home. I'm not sure what to do?

Kind of sounds like you need to be "boots on the ground" for this. You're getting conflicting stories.

MY FIL would not allow the female nurses or aids to bathe him or change his briefs, The males were called in. Problem solved.

You cannot let a urine soaked depends sit next to delicate papery "old people's" skin. It will break down and cause such a problem.

Probably worth the drive to see what's really happening.

I agree with Ahmijoy. Aides really don't have the time to talk residents in doing what is needed. My daughter would approach it with "Mr. Smith. I understand me helping is a little uncomfortable but wouldn't you feel so much better with nice clean clothes and briefs?" She says you make them think they made the choice. Even if Dad was not competent, they can't force him to do. Its against State laws.

For a person to refuse or tell you they didn't offer when they did, there is some decline here. Really, who in their right mind wants to sit in a cold wet depends.

The staff on weekends are not necessaily the the staff during the week. So they may not to really help you. So I would try to go during the week.

Would he be more comfortable with a male aide? Dad is not going to admit that he is not cooperating with the aides. And the busy aides don’t have time to cajole upwards of 15-20 patients in their care to cooperate. But skin breakdown in serious. That’s a bathing issue as well.

Have there been any other issues with his care that you can corroborate, not just based on what he tells you? 150 miles is not the other side of the world and you may need to run up on a Friday night for the weekend to speak personally with his care team. This way you will have a clear picture of what is and what is not going on.

Have you done this already?

You call the person in charge and you ask them to go while you are on the phone with your father and offer to help so you can hear for yourself what is happening.
OR- Ask him to call for help right then while you are on the phone with him and wait until they come and listen to the exchange.

Who told you that his skin was breaking down?

You are getting two different stories, so you need to get both sides together. That probably includes the Director as well as any individual nursing aide. This is clearly unacceptable care, and equally clearly something is going wrong with your father's 'competence' diagnosis.