Failure to Provide Showers/Baths per Resident Preference and Plan of Care
Penalty
Summary
The facility failed to provide showers or baths according to the resident's preference and plan of care for one resident reviewed for Activities of Daily Living (ADL) care. The resident, who had multiple diagnoses including obstructive lung disease, heart failure, anemia, depression, anxiety, venous insufficiency, diabetes, hypertension, and arthritis, was noted to have severe cognitive impairment with a BIMS score of 2, as well as behavioral symptoms such as inattention, disorganized thinking, and rejection of care. The care plan indicated the resident required substantial to maximal assistance with bathing due to functional deficits. Documentation revealed that in March, the resident received only a few showers or baths, with some refusals, and only one documented shower or bath in April. No showers or baths were documented in May prior to discharge. Interviews with facility staff confirmed that the available documentation was complete and that there were significant gaps in the provision of showers or baths, with only one documented in April and none in May. The DON acknowledged that residents should generally be offered showers or baths twice per week according to their preferences. The facility's policy required that residents receive necessary assistance to maintain hygiene, with showers or baths scheduled according to person-centered care. The lack of consistent bathing was corroborated by a family member, who reported that the resident rarely received showers or baths, leading to dissatisfaction with care.