Failure to Provide and Document Scheduled Showers for Dependent Residents
Penalty
Summary
The facility failed to provide scheduled showers and document bathing care for four residents who required assistance with activities of daily living, specifically bathing and hygiene. Facility policy required that residents be bathed or showered according to their preferences at least twice per week, with refusals to be reported and documented. However, for multiple residents, there was no documented evidence that their bathing preferences were obtained or followed, and no record of showers or refusals as required by policy. One resident, who was cognitively intact and required assistance with bathing and toileting hygiene, reported receiving only one shower during a two-week stay, with no documentation of bathing preferences or scheduled showers in the clinical record. Another resident, also cognitively intact and with frequent incontinence, had physician orders and a care plan specifying showers on certain days, but there was no documentation that these showers were provided or refused, nor that bed baths were offered as an alternative. Two additional residents, one cognitively impaired and the other cognitively intact, both had physician orders and care plans specifying regular showers and documentation of refusals. For both, there was no evidence in the records that showers were provided as ordered, nor that refusals or alternative care were documented. The DON confirmed the lack of documentation for all four residents, indicating a failure to provide and record necessary bathing care as per facility policy and physician orders.
Plan Of Correction
Residents # 4, 5, 6, and 7 have had no adverse effects from not being showered according to preference. Residents 4, 5, 6, and 7 were showered according to preference as care planned. To identify residents who have the potential to be affected, the Director of Nursing/designee will complete an audit of shower preferences and ensure care plans are accurate. To prevent recurrence, the licensed nursing staff and nurse aides will be educated on the facility Resident bathing/showering/scheduling policy by the Director of Nursing/designee. To maintain and monitor compliance, audits of 6 residents to ensure showers are completed according to preference audits will be completed weekly x 4 and monthly x 2.