Failure to Provide Scheduled Showers
Penalty
Summary
The facility failed to provide showers per resident preference and as scheduled for a resident who was dependent on staff for activities of daily living. The resident, who had intact cognition and required extensive assistance for personal hygiene, preferred showers three times a week. However, the facility did not adhere to this schedule, as evidenced by the resident's report of not receiving showers as scheduled and the facility's records showing missed showers on multiple occasions. The resident expressed that he was not asked if he wanted a shower on scheduled days and sometimes received a bed bath instead, which was not his preference. Interviews with staff revealed inconsistencies in the documentation and communication regarding the resident's care. Certified Nursing Assistants (CNAs) stated they informed nurses when the resident refused showers and provided bed baths instead, but there was no documentation of refusals in the resident's progress notes. The Registered Nurse and Unit Manager were unaware of any refusals, and the Director of Nursing expected refusals to be documented, which was not done. The facility's policy required showers to be provided as per request or schedule, but this was not consistently followed, leading to the deficiency.
Plan Of Correction
Resident #75 received a shower per his preference and receives showers as scheduled. If he refuses his scheduled shower, the CNAs will document the refusal and notify the nurse. Resident's care plan was updated to offer a bed bath if the resident declines a shower. An audit was completed to ensure showers were completed per the resident preference and as scheduled, with refusals documented. Any discrepancies were corrected as appropriate. The DON and/or designee will in-service the CNAs and licensed staff to provide showers per resident preference and as scheduled, including documentation of resident refusal and notification of the nurse. Staff will honor resident preferences for showers. Resident preferences will be care planned. Random weekly audits of five residents for each floor/unit will be completed by the DON/designee to provide showers per resident preference and as scheduled, including documentation of resident refusal. The audits will be completed weekly for a minimum of three months or until significant compliance has been met. The results of the audits will be forwarded to the Administrator for review and discussed at the monthly QAPI committee meeting. The committee will direct improvement to the plan when necessary to achieve and maintain compliance.