Failure to Provide and Document Adequate Bathing Assistance
Penalty
Summary
The facility failed to provide necessary services to maintain personal hygiene for one resident who was dependent on staff for activities of daily living (ADLs), specifically bathing. The resident, a male with diagnoses including osteomyelitis, functional quadriplegia, and dependence on renal dialysis, was found to have received only three showers or baths in March and none in April, according to the facility's shower logs. The resident reported feeling unclean and stated he had only received four bed baths in the 90 days he had been at the facility. Interviews with staff revealed inconsistencies in the documentation and provision of bathing care. Certified Nursing Assistants (CNAs) and nursing staff acknowledged that the resident often preferred bed baths and sometimes refused showers, but also admitted that refusals were not always documented as required. Staff also cited scheduling conflicts with dialysis treatments as a reason for missed showers, and there was confusion about the whereabouts of shower sheets for certain months. The Assistant Director of Nursing (ADON) and Director of Nursing (DON) confirmed that documentation should be completed for every scheduled shower, regardless of whether the resident accepted or refused, and that the lack of documentation and missed showers was a problem. The facility's policy required that residents unable to perform ADLs independently receive appropriate support and assistance with hygiene, including bathing, in accordance with their care plan. Despite this, the resident's care plan interventions for bathing were not consistently followed or documented, resulting in inadequate hygiene care over the review period.