Failure to Accommodate Resident's Showering Preference Due to Inadequate Coordination for Port Dressing
Penalty
Summary
The facility failed to provide or document showers for a resident who was admitted with end stage renal disease requiring dialysis, a malignant neoplasm of the left breast, and a need for assistance with personal care. Despite the resident's expressed preference and ability to shower with her dialysis port covered, she did not receive a shower during her stay. The resident reported that prior to admission, she managed to shower safely by covering her port with a product from a pharmacy, but after admission, staff repeatedly told her they were waiting for a physician's order for a dressing to cover her port, which was never obtained or documented. The resident denied ever refusing a shower, stating she only needed her port covered to do so. Observations confirmed that the resident's shower was unused, and her towels remained dry and folded. Record review showed that the resident only received sponge baths and that documentation indicated refusals for showers, but there was no evidence of attempts to contact the physician for a dressing order or to accommodate her showering preference. The DON later confirmed that Tegaderm dressings, which could be used to cover the port, were available in stock and did not require a physician's order, and that the resident could have had a shower at any time. The facility's policy required that residents receive care in accordance with their choices and professional standards, but there was no documentation that the resident's preference for showers was accommodated or that appropriate steps were taken to enable her to shower safely.