Failure to Provide Scheduled Showers and Document Refusals for Dependent Resident
Penalty
Summary
A deficiency occurred when a resident who was dependent on staff for activities of daily living (ADLs), including bathing, was not provided showers as scheduled over a period of several weeks. The resident's care plan indicated a need for extensive to total assistance with ADLs, and the facility's shower schedule specified that the resident should receive showers twice weekly. However, documentation revealed that during the months of January, February, and March, the resident did not receive scheduled showers and, in some weeks, received only one bed bath. There was no documented evidence that showers were offered or refused by the resident during this time. Interviews with staff confirmed that the resident was supposed to be offered showers at least twice a week, and if refused, additional attempts should have been made and refusals reported to the charge nurse. The Director of Nursing verified that showers were not provided on the scheduled dates and that documentation did not reflect whether showers were offered or refused. The documentation codes used did not indicate if the resident had refused showers, and there was no evidence that a shower was offered before a bed bath was given. The facility's policy required that residents unable to perform ADLs independently receive necessary services to maintain personal hygiene, including bathing, and that refusals be documented with attempts to address the underlying cause. The lack of documentation and failure to provide scheduled showers or record refusals constituted a failure to follow the care plan and facility policy for supporting ADLs and maintaining hygiene for a dependent resident.