Failure to Provide Scheduled Showers and ADL Assistance
Penalty
Summary
A deficiency occurred when a resident who required assistance with activities of daily living (ADLs), including bathing and showering, did not receive showers as scheduled or requested. The resident, who had a history of cerebrovascular accident (CVA) resulting in limited mobility and required two staff members for transfers, reported not receiving showers and only receiving inconsistent bed baths. The resident stated he had not received a bed bath in about two weeks and expressed distress over his hygiene. Review of the care plan confirmed the need for ADL assistance, and the shower schedule indicated the resident was to receive showers twice weekly. However, documentation for April and May showed no record of showers or refusals, and only four bed baths were documented in May, with no shower sheets available for April. Interviews with staff revealed confusion regarding responsibility for providing showers, with a CNA stating hospice was responsible and an LPN confirming multiple calls to hospice without response. The LPN also stated that facility CNAs would provide bed baths when hospice did not come, but confirmed the resident had not received a shower. The Director of Nursing acknowledged that residents should receive showers according to their preferences and schedule, regardless of hospice involvement. This lack of coordination and documentation led to the resident not receiving the necessary ADL care for bathing and showering.