Failure to Provide Bathing Assistance per Resident Preferences and Care Plan
Penalty
Summary
The facility failed to ensure that a resident received assistance with bathing and showers according to her documented preferences and care plan. The resident, who had multiple diagnoses including COPD, diabetes with neuropathy, chronic pain, atrial fibrillation, gout, depression, psychosis, and mild cognitive impairment, required substantial assistance for bathing and toileting hygiene. Her care plan specified a preference for one bed bath and one shower per week, and the physician's order supported a shower schedule based on her preferences or facility protocol. However, review of the electronic medical record and shower schedules showed that the resident primarily received bed baths and not showers as scheduled, with several instances where there was no documentation of any bathing or refusals. There were also no paper shower sheets documenting refusals or completed showers after a certain date. Interviews with the resident, her representative, CNAs, and the DON confirmed that the resident was not receiving showers as planned, and that the shower in her room was often inaccessible due to equipment being stored in the bathroom. Staff interviews indicated that while shower schedules and documentation protocols existed, they were not consistently followed, and the resident mostly received bed baths instead of showers. The facility's policy required provision of ADL care in accordance with resident consent and care plans, but this was not adhered to for this resident.