Failure to Provide and Document Required Bathing and Personal Hygiene
Penalty
Summary
The facility failed to provide adequate personal hygiene and bathing assistance to two residents who required substantial or maximal help with activities of daily living (ADLs). Facility policy required that residents be offered the required number of showers each week and that cleanliness be promoted. For one resident with cerebral infarction, gastrostomy, anxiety, and depression, who was cognitively intact and dependent on staff for bathing and transfers, documentation showed that bathing was not provided or not documented for 35 out of 53 days reviewed. Observations over several days revealed a strong foul smell of body odor in the resident's room. For another resident with Alzheimer's disease, diabetes, and COPD, who was severely cognitively impaired and also dependent on staff for bathing and transfers, documentation indicated that bathing was not provided or not documented for 37 out of 53 days reviewed. This resident was also observed to have a strong foul smell of body odor and dirty, disheveled hair during multiple visits. Interviews with facility staff confirmed that residents should be offered showers on scheduled dates and that care provided or refused should be documented. The Director of Nursing acknowledged the expectation for documentation, and an LPN confirmed the presence of a strong, unpleasant odor in the residents' rooms, which could be attributed to body odor. The facility was unable to provide documentation that the affected residents were offered or received bathing as required by policy and care plans.