Failure to Provide Showers and Personal Hygiene Care According to Resident Preferences
Penalty
Summary
The facility failed to ensure that showers and personal hygiene care were provided to residents according to their stated preferences and care plans. For one resident with hemiplegia and hemiparesis, documentation showed that he was scheduled for multiple showers but only received a portion of them, with some marked as refused or not applicable without proper justification. The resident reported not receiving the expected number of showers and being asked to sign off on shower sheets even when showers were not provided. The care plan and resident preference documents indicated a clear expectation for shower frequency and choice, but the facility's records and staff interviews revealed inconsistencies in both the provision and documentation of care. Another resident with paroxysmal atrial fibrillation and congestive heart failure was observed with poor personal hygiene, specifically debris under her fingernails, despite care plans indicating a need for assistance with ADLs, including bathing and nail care. Documentation showed gaps in the provision of nail care and hair washing, and there was a lack of refusal documentation for missed care. Staff interviews confirmed that shower sheets and point-of-care (POC) documentation should match, but discrepancies were found between the two, and some care activities were not consistently recorded. A third resident with multiple sclerosis and a recent patella fracture had conflicting documentation regarding bathing preferences and physician orders. While the care plan and task section of the electronic medical record indicated a preference for showers, a physician's order for bed baths only remained in the chart, and the resident did not receive showers as scheduled. Staff interviews revealed confusion about the resident's current preferences and orders, and the facility lacked a specific policy for documenting resident preferences, leading to inconsistencies in care delivery and record-keeping.