Failure to Provide Consistent Bathing and Grooming for Resident with Cognitive Impairment
Penalty
Summary
A deficiency occurred when the facility failed to provide consistent bathing and grooming care for a resident with multiple mental health diagnoses, including dementia, bipolar disorder, schizoaffective disorder, and major depressive disorder. The resident's medical records indicated a progression from moderately to severely impaired cognition over time, with documented needs for assistance or supervision with activities of daily living (ADLs) such as oral hygiene, dressing, and personal hygiene. Despite these needs, the resident did not receive showers for extended periods, including gaps of 12, 17, and 9 consecutive days, with only two documented refusals during these times. Observations showed the resident was repeatedly unshaven and had disheveled hair on multiple occasions. Staff interviews revealed that when the resident refused showers, staff would attempt to reapproach or offer alternatives, and were instructed to notify nursing staff and document refusals. However, the care plan lacked specific interventions for ADLs or for managing refusals of care. The facility's policy required documentation of refusals, education about risks and benefits, and substitute interventions, but these were not consistently documented or implemented. This failure to provide and document necessary care and services for ADLs resulted in the resident not receiving adequate hygiene and grooming support.