Failure to Provide Consistent Bathing and Grooming for a Resident with Impaired Cognition
Penalty
Summary
The facility failed to provide consistent bathing and grooming care for one resident with multiple diagnoses, including dementia, anxiety, hypertension, atrial fibrillation, cognitive communication deficit, and depression. The resident was assessed as having severely impaired thinking and required partial staff assistance for activities of daily living (ADLs) such as dressing, mobility, transfers, ambulation, personal hygiene, and showers. Documentation showed that the resident frequently refused showers or bed baths, with extended periods where no bathing occurred, including gaps of up to 26 days. The care plan directed staff to explain care activities, negotiate ADL times, and provide consistency in caregivers and routines, but records indicated that only one staff member was allowed to attempt showers, and documentation of repeated attempts was lacking. Observations over several days revealed the resident had uncombed, tangled, and matted hair and wore the same clothes for over a week. Staff interviews confirmed that the resident often refused showers and changes of clothes, and that only one staff member was permitted to attempt showers, which limited opportunities for care. Nursing staff and administration acknowledged the resident's resistance to care and stated that the family was aware of the situation and did not wish to be contacted for each refusal. Despite these challenges, the facility's policy required that residents unable to perform ADLs receive services to maintain good hygiene and grooming, which was not consistently provided in this case.