Failure to Provide Scheduled Bathing Assistance to Dependent Residents
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs), specifically bathing, to two residents who were unable to perform these tasks independently. One resident, a female with diagnoses including cardiomegaly, dementia with behavioral disturbance, morbid obesity, urogenital candidiasis, and rheumatoid arthritis, required substantial to maximal assistance for bathing and had no behaviors of care rejection. Her care plan specified a bed bath on Monday, Wednesday, and Friday with one staff assist. However, CNA flowsheets and resident interviews confirmed that scheduled bed baths were missed on multiple occasions, with only one bath documented over a one-week period. Staffing shortages were cited by CNAs as a reason for not completing all scheduled baths. Another resident, also a female with heart disease, dementia, morbid obesity, schizophrenia, and heart failure, required moderate assistance from two staff for bathing and was noted to be occasionally resistive to care. Her care plan included strategies for negotiating ADL times and re-approaching if she was initially resistive. Despite this, CNA documentation and resident interviews indicated that scheduled bed baths were not consistently provided, with only two baths given in a week and several missed on scheduled days. The DON acknowledged staffing challenges and the impact on the ability to provide scheduled baths, while the administrator confirmed the expectation that residents receive their scheduled hygiene care.