Failure to Offer Alternative Hygiene Options After Bath Refusal
Penalty
Summary
The facility failed to ensure that a resident who refused a bed bath was offered an alternative option for personal hygiene. During a period when regular showers could not be provided due to a plumbing issue, the resident, who has eczema and a physician's order for topical cream to manage skin dryness and scabs, was offered a bed bath as an alternative to a shower. After initially accepting, the resident refused a subsequent bed bath, expressing concern that soap would not be rinsed off properly, potentially aggravating his skin condition. There was no documented evidence that any other alternative was offered after the refusal, nor was there documentation that the reason for refusal was explored or addressed. Interviews with CNAs revealed a lack of awareness regarding alternative options when a resident refuses a bed bath, with staff indicating they would simply notify licensed nurses but did not know what further steps to take. The DON confirmed that staff were expected to offer alternatives, such as coordinating with family for a shower at home, but this was not done. Facility records and policy review confirmed the absence of documented alternative options or follow-up actions to support the resident's hygiene needs in a person-centered manner.