Failure to Honor Resident's Bathing Preferences and Support Self-Determination
Penalty
Summary
A deficiency was identified when a resident's right to self-determination and choice regarding bathing preferences was not honored. The resident, who is cognitively intact with a BIMS score of 15, reported not receiving a shower for approximately three weeks, despite expressing a preference for showers over bed baths. The resident also stated that his requests for specific types of incontinence briefs and linen changes were not consistently met, and that his leaking toilet had not been addressed. Staff interviews confirmed that the resident required assistance with activities of daily living (ADLs) and that there were inconsistencies in providing showers according to the resident's preferences and the facility's updated shower schedule. Review of facility documentation, including the resident's care plan, Kardex, and ADL task sheets, revealed that the resident was scheduled to receive showers on Monday, Wednesday, and Friday during the 7AM-3PM shift. However, records for April and May showed multiple instances where showers were not documented, and the resident often received sponge baths or full baths instead. There was also a lack of documentation indicating that the resident refused showers, as required by facility policy. The grievance log and Resident Council minutes indicated that the resident had previously raised concerns about not receiving showers as preferred, and the issue was marked as resolved after the shower schedule was updated, but subsequent documentation did not support consistent implementation of this schedule. Facility policy requires that all residents be offered and provided a shower unless they specifically request a bed bath, and any refusal must be documented with appropriate notifications. In this case, the lack of consistent documentation and failure to provide showers as scheduled demonstrated that the facility did not fully support or facilitate the resident's right to choose their preferred method of bathing, resulting in a deficiency.