Failure to Provide Scheduled Showers and Maintain Hygiene for Dependent Resident
Penalty
Summary
The facility failed to ensure that a resident who was dependent on staff for activities of daily living (ADLs) received the necessary services to maintain good grooming and personal hygiene, specifically by not providing showers according to the resident's preferences and the facility's own schedule. The resident, who had diagnoses including amyotrophic lateral sclerosis, subdural hemorrhage, protein-calorie malnutrition, and dysphagia, was cognitively intact and required staff assistance for toileting, dressing, bed mobility, and transfers. Observations over multiple days showed the resident with greasy, unwashed hair, and the resident communicated that she had not received a shower in about 10 days, expressing a preference for at least one shower every seven days. Review of documentation revealed significant gaps in shower provision and record-keeping. The facility's policy required documentation of showers, refusals, and any interventions, but records showed that the resident received only two showers over a 30-day period, despite being scheduled for two showers per week. There was no documentation of shower refusals or reasons for missed showers in the electronic medical record, and the shower schedule had not been updated to reflect the resident's preferences since before her admission. Interviews with staff indicated that the designated shower aide was frequently reassigned to floor duties, leaving CNAs responsible for showers, but documentation and communication about completed showers and refusals were inconsistent. Staff were aware of the importance of showers for hygiene and skin integrity, but the lack of updated schedules, incomplete documentation, and inconsistent assignment of shower duties led to the resident not receiving showers as scheduled or preferred.