Failure to Provide Scheduled Bathing and Timely Toileting Assistance
Penalty
Summary
The facility failed to ensure that residents received baths at the frequency required by their care plans, specifically twice a week or as requested, for six residents reviewed. Documentation revealed multiple instances where baths were not offered or documented as being offered, particularly after a resident refused or when 'not applicable' was recorded. In several cases, there were extended periods where no bath was documented, and residents reported receiving baths far less frequently than scheduled. Some residents also reported not being offered alternative hygiene measures, such as washcloths for freshening up, when baths were missed. Additionally, the facility failed to provide timely toileting assistance for two residents. Residents described long wait times for call lights to be answered, sometimes up to an hour, resulting in incontinence episodes and discomfort. Staff interviews confirmed that staffing shortages contributed to delays in providing care, including both bathing and toileting assistance. Staff also reported that when there were not enough CNAs on shift, baths would be postponed or missed entirely, and documentation practices included marking 'not applicable' when baths were not completed due to staffing issues. Resident council notes and grievances further corroborated concerns about inadequate bathing and nail care. Staff interviews revealed inconsistent practices regarding documentation and follow-up when residents refused baths, as well as reliance on the next shift to complete missed baths. Observations of residents confirmed poor hygiene, such as long and dirty fingernails and strong odors, further evidencing the lack of consistent care. Facility policy required documentation of refusals and notification of supervisors, but these procedures were not consistently followed.