Failure to Provide Required Bathing Assistance for Dependent Residents
Penalty
Summary
The facility failed to provide necessary assistance with bathing and personal hygiene for two residents who were unable to perform activities of daily living (ADLs) independently. One resident, who was quadriplegic and dependent on staff for all ADLs, did not receive any documented baths or showers for a period of 20 days following admission, despite being scheduled for bed baths twice weekly. The resident reported not receiving showers due to the lack of an appropriate shower chair, and staff confirmed that spa shower rooms were unavailable as they were being used for other purposes. The resident's care plan and Kardex indicated a need for substantial or maximal assistance with bathing, but there was no evidence this care was provided. Another resident, admitted with a hip fracture and difficulty walking, required supervision or touching assistance with bathing according to her care plan and Kardex. However, staff only provided setup assistance, leaving the resident to shower independently despite her recent fall and mobility limitations. The resident reported that staff did not offer showers as scheduled and that she was left alone during bathing, contrary to her care plan requirements. Documentation in the electronic medical record reflected only setup assistance, not the required level of supervision or physical help. Interviews with CNAs and nursing staff revealed inconsistencies in understanding and following the residents' care plans and assistance levels. Staff relied on various sources for information, such as white boards, paper reports, and the EMR, but did not consistently provide the level of care specified in the residents' plans. The DON acknowledged the lack of documentation for one resident's bathing and recognized that staff were not providing the required supervision for the other resident. The facility's failure to ensure that residents received the necessary services for bathing and personal hygiene resulted in unmet care needs for both individuals.