Failure to Provide Adequate Bathing and Grooming Assistance
Penalty
Summary
The facility failed to provide adequate assistance with bathing and grooming for eight out of thirteen residents reviewed for activities of daily living (ADL) assistance. Multiple residents, some with intact cognition and others with cognitive impairment, did not receive the required number of baths or showers as documented in their care plans and facility policy. Documentation revealed significant gaps between bathing dates, with some residents going up to 20 days without a bath or shower. In several cases, there was no evidence that staff re-approached residents after refusals or communicated missed baths/showers, and documentation of care provided was inconsistent or missing. Residents with various medical conditions, including heart failure, dementia, depression, obesity, and mobility impairments, were affected by these deficiencies. For example, one resident with heart failure and depression reported receiving only one bath per week due to short staffing, and documentation confirmed long intervals between baths. Another resident with severe cognitive impairment was observed with disheveled and matted hair, and records showed a lack of regular personal hygiene assistance. Several residents reported directly to surveyors that they did not receive the expected frequency of bathing, and some expressed dissatisfaction with the quality of care, including inadequate drying after bathing and lack of assistance with oral hygiene, hair care, and dressing. Staff interviews corroborated the documentation and resident reports, with CNAs and the DON acknowledging challenges in meeting residents' ADL needs due to staffing shortages and high acuity. Observations included residents with oily hair, musty odors, unchanged clothing, and unaddressed toileting needs. The facility's own records and staff statements confirmed that the required assistance with ADLs, including bathing, grooming, and hygiene, was not consistently provided, and that documentation of refusals or alternate attempts was lacking.