Failure to Provide Scheduled and Preferred Bathing for Dependent Resident
Penalty
Summary
Facility staff failed to ensure that a resident who was dependent on staff for activities of daily living (ADLs) received bathing in accordance with her preferences and scheduled care. The resident, who had significant medical conditions including encephalopathy, type 2 diabetes, aphasia, chronic pain syndrome, hemiplegia, and cognitive impairment, required substantial to maximal assistance for bathing and personal hygiene. The care plan indicated a preference for showers and required staff to report refusals of ADL care to the nurse. However, the care plan did not address the resident's use of or fear of the shower chair. Documentation of bathing was inconsistent and did not specify the type of bathing provided. The resident was not bathed on several scheduled days, and behavior monitoring records did not clarify which care was refused. Interviews revealed that the resident preferred showers but was afraid of or experienced pain with the shower chair, resulting in bed baths being provided instead. Staff interviews confirmed that the resident was not consistently bathed as scheduled and that refusals or issues with bathing were not always communicated or documented as required. The Unit Manager and DON were unaware of the resident's discomfort with the shower chair and the missed scheduled baths. Facility policy required showers or baths to be scheduled according to person-centered care, but this was not consistently followed for the resident in question.