Failure to Provide Scheduled Showers and ADL Support
Penalty
Summary
A deficiency was identified when a resident with quadriplegia, epilepsy, blindness, arthritis, and non-Alzheimer's dementia, who required extensive assistance from two staff members for activities of daily living (ADLs), did not receive showers as scheduled. Observation revealed the resident had a large amount of facial hair on her chin and brown substance under her fingernails. The resident's care plan specified a preference for showers on Monday and Thursday evenings with staff assistance, and the shower schedule confirmed these days. However, documentation showed that showers were not provided on several scheduled dates in March and April, and there was no record of the resident refusing showers during this period. Review of the facility's ADL policy indicated that residents unable to perform ADLs independently should receive necessary services to maintain hygiene, including bathing, in accordance with their care plan. The Director of Nursing was unable to provide additional documentation to account for the missed showers, and the Quality Assurance Administrator confirmed the policy in use. The lack of documentation for both the provision of showers and any refusals constituted a failure to provide the required ADL care as outlined in the resident's care plan.