Failure to Provide Regular Showers and Effective Oral Care
Penalty
Summary
The facility failed to follow its policies regarding activities of daily living (ADLs), specifically in providing regular showers and effective oral care to residents. One resident with chronic respiratory failure, tracheostomy status, and weakness was observed with yellow mucus and raised white/yellow patches in the mouth, and reported not having received oral care in two weeks. Staff confirmed the presence of what appeared to be thrush and provided oral care only after the issue was identified by the surveyor. The infectious disease nurse noted that the resident was at higher risk for infections due to medications and tracheostomy and required prescription mouthwash for the infection. Another resident reported not having had a shower since before a recent hospital stay and expressed a desire for a shower, with no documentation of refusal. Staff interviews revealed confusion about shower responsibilities and documentation, with some staff equating bed baths to showers. The resident's care plan did not address bathing or shower preferences, and there was no evidence that showers were offered or refused as required by facility policy. The facility's own policies state that residents should be offered a bath or shower at least weekly, and assistance should be provided as needed, but these were not followed for the residents reviewed.