Failure to Provide Scheduled Showers and Hair Care for Dependent Residents
Penalty
Summary
The facility failed to provide adequate care and assistance with activities of daily living (ADLs), specifically bathing and hair care, for 9 out of 10 residents reviewed. Multiple residents who were dependent on staff for bathing and personal hygiene did not receive showers or hair shampooing according to their care plans and preferences. Observations and interviews revealed that residents often received bed baths without hair washing, and some residents' hair appeared oily, unkempt, or unwashed. Several residents and family members reported infrequent showers, lack of haircuts, and inadequate hygiene, with some residents expressing dissatisfaction with the timing and quality of care provided. Clinical record reviews indicated that these residents had significant medical conditions such as cerebral palsy, diabetes mellitus, dementia, depression, hypertensive encephalopathy, and malignant neoplasm, and required varying levels of staff assistance for ADLs. Documentation showed missed showers on multiple scheduled days for each resident, and in some cases, no documentation of hair washing since admission. Care plans consistently indicated a preference for showers two times per week, but these preferences were not met. Staff interviews confirmed ongoing issues with staffing shortages, which contributed to the inability to complete all required ADL care. The Director of Nursing acknowledged that the facility was aware of the ongoing problem with missed ADL care, including showers, and that there was no designated staff member responsible for ensuring showers were given. Facility policy required that residents be offered showers or baths according to their preferences at least twice weekly, but this was not consistently implemented. The deficiency was cited under 3.1-38(a)(3) and related to specific complaints.