Failure to Provide Scheduled Showers and Document ADL Care
Penalty
Summary
The facility failed to provide scheduled showers to three dependent residents who required assistance with activities of daily living (ADLs), specifically bathing. Review of the electronic medical records (EMR) and interviews revealed that one resident with Alzheimer's disease, who was moderately cognitively impaired and required substantial assistance, only received two showers in a month despite being scheduled for three showers per week. The resident expressed missing her baths, and staff confirmed her scheduled shower days and the documentation process. Another resident with hereditary and idiopathic neuropathy, also with moderate cognitive impairment and requiring partial to moderate assistance, did not consistently receive showers according to her three-times-weekly schedule. Documentation showed significant gaps in shower provision, and both the resident and her Power of Attorney (POA) reported that showers were often missed and refusals were inaccurately documented. The resident stated she rarely refused showers and often requested them without staff following through. A third resident with chronic atrial fibrillation and moderate cognitive impairment, requiring substantial to maximum assistance, received very few showers over several months, with documentation indicating almost no showers and no refusals. The resident and her POA were unaware of her bathing schedule, and the resident reported rarely being showered and not having her hair washed since admission. Staff interviews confirmed that if showers or refusals were not documented, the care was not provided. The Director of Nursing acknowledged the lack of documentation and the absence of a facility policy related to showering and ADL care.