Failure to Provide Bathing per Resident Preference and Care Plan
Penalty
Summary
A deficiency occurred when a resident with paraplegia and significant self-care deficits did not receive bathing services according to their preferences and care plan. The resident, who was totally dependent on staff for hygiene and transfers, was only provided bed baths because staff believed he lacked the trunk support necessary to use a shower chair. Staff were unfamiliar with the use of a shower bed, which was only located and utilized after a significant period. Documentation showed that the resident received only one shower over several weeks, with multiple gaps where showers were not offered or documented, and some refusals not followed up with additional offers. The resident expressed a desire for a real shower at least once a week, but staff continued to provide only bed baths until the shower bed was found. The facility's policy required staff to assist with bathing to promote cleanliness and dignity and to notify the charge nurse of refusals, but records indicated inconsistent documentation and lack of regular shower offers. The resident's medical history included neurogenic bladder, paraplegia, recurrent hip dislocation, pressure ulcer, insomnia, and adult failure to thrive, and he was totally dependent on staff for all ADLs.