Failure to Provide Scheduled Showers and Hygiene Assistance
Penalty
Summary
The facility failed to provide showers and bathing assistance to residents according to their preferences and the established shower schedule. Multiple residents who required substantial or maximal assistance for activities of daily living (ADLs), including bathing, did not receive showers as scheduled. Documentation and direct observations confirmed that several residents had not received showers or hair washing for extended periods, despite being dependent on staff for these tasks. The facility had recently changed its process by discontinuing dedicated shower aides and assigning all CNAs to handle shower duties, which contributed to the missed care. Specific residents affected included individuals with significant medical conditions such as lumbago with sciatica, chronic kidney disease, hemiplegia, malnutrition, and cognitive deficits. These residents were observed to be unkempt, with greasy or unwashed hair, and in some cases, soiled clothing. Interviews with the residents and the DON confirmed that showers and hygiene care were not provided as scheduled, and documentation was either missing or incomplete. Residents expressed dissatisfaction with their hygiene care, noting that they had not received showers or shaves as they preferred and as outlined in their care plans. Facility policy required that residents be interviewed about their bathing preferences upon admission and that these preferences be reviewed quarterly. However, the lack of adherence to the shower schedule and resident preferences, as well as the absence of proper documentation, demonstrated a failure to follow this policy. The DON and Administrator verified the missed showers and incomplete records, confirming the deficiency in providing necessary care and assistance for activities of daily living.