Failure to Provide and Document Scheduled Showers for a Resident
Penalty
Summary
A deficiency occurred when a resident with chronic obstructive pulmonary disease, convulsions, and generalized muscle weakness did not receive scheduled showers as required by the facility's policy. The resident was cognitively intact, as indicated by a BIMS score of 15, and was able to communicate his needs. Despite being scheduled for showers twice a week, documentation and interviews revealed that the resident did not receive showers according to the established schedule, and there was no evidence of refusals or alternative bathing options being offered or documented. Multiple staff interviews confirmed that the resident's showers were not provided as scheduled, and that documentation was inconsistent or missing for several dates. Certified Nurse Assistants (CNAs) and Licensed Nurses (LNs) acknowledged that showers were important for hygiene, skin assessment, and resident dignity, but records showed only a few bed baths and showers were documented, with several scheduled showers lacking any documentation. The facility's own monitoring reports and shower sheets further indicated gaps in both the provision and documentation of bathing care. The facility's policy required thorough documentation of all showers, refusals, and skin assessments, but this was not consistently followed. The Director of Nursing and Director of Staff Development both confirmed that the expected documentation was incomplete and that the resident missed scheduled showers without proper record of refusals or alternative care. This failure to provide and document scheduled showers had the potential to negatively impact the resident's personal hygiene and psychosocial well-being.