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F0561
D

Failure to Honor Resident Bathing Preferences

Gretna, Nebraska Survey Completed on 05-05-2025

Penalty

21 days payment denial
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to provide bathing services in accordance with the preferences of four residents, as identified through interviews and record reviews. Each resident had documented preferences for receiving two baths or showers per week, as indicated in their care plans or preference forms. However, facility records for March and April 2025 showed that these residents did not receive the number of baths or showers they preferred. For example, one resident with severe cognitive impairment and requiring total assistance for bathing received only five baths over an eight-week period, instead of the expected sixteen. Another resident, who was cognitively intact and required extensive assistance, received only three baths over a five-week period, instead of the expected ten. Similar discrepancies were found for the other two residents, with one resident refusing a bath on one occasion, but otherwise not receiving the preferred number of showers. The residents involved had varying levels of cognitive and physical impairment, as assessed by the Minimum Data Set (MDS), and all required significant assistance with bathing and other activities of daily living. The facility's own policy emphasized the right of residents to self-determination and to make choices about their care, including bathing schedules. Despite this, the facility did not honor the residents' stated preferences for bathing frequency, as confirmed by the Director of Nursing during an interview. This failure to provide care in accordance with resident choice constitutes a deficiency in supporting resident rights and self-determination.

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