Failure to Provide Bathing per Resident Preference Due to Staffing and Documentation Issues
Penalty
Summary
The facility failed to honor and facilitate resident self-determination regarding bathing preferences for two residents. For one resident with polyneuropathy and restless leg syndrome, who was cognitively intact and required maximum assistance for bathing, there were no care plan interventions or social service assessments addressing bathing preferences. Bathing logs and schedules showed infrequent baths, and the resident confirmed not having a bath for at least a month, attributing this to staff shortages. Staff interviews corroborated that baths were not being provided weekly as expected, and the Director of Nursing confirmed that bath logs were discarded after documentation in the electronic medical record. The facility also lacked a specific bathing policy. Another resident, who required supervision or touching assistance with activities of daily living and had a moderate cognitive impairment, was observed with oily hair and could not recall the last time they had a bath or washed their hair. Bathing logs indicated only one or two baths per month, and there was no documentation of bed baths or refusals in the progress notes. The resident's care plan did not include bathing interventions or preferences, and staff interviews confirmed that there was not a daily bath aide scheduled and that staffing shortages impacted the ability to provide regular baths. Throughout the review, it was confirmed by multiple staff, including the Administrator and DON, that the facility did not have a formal bathing policy and that resident preferences for bathing were not consistently assessed or care planned. Documentation of bathing and refusals was inconsistent, and staffing limitations were cited as a reason for not meeting the expected frequency of weekly baths based on resident preferences.