Failure to Provide Required Bathing Assistance and Timely Care Planning
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs), specifically bathing and personal hygiene, to a resident who was unable to perform these tasks independently. The resident, admitted with diagnoses including atrial fibrillation, generalized idiopathic epilepsy, and osteoporosis, was assessed as having moderately impaired cognitive skills and required maximum staff assistance for bathing. Documentation revealed that the resident did not receive scheduled showers during two separate periods, with gaps from 2/1/2025 to 2/16/2025 and from 4/17/2025 to 4/28/2025. Interviews with staff confirmed that the resident often refused showers, particularly when their preferred CNA was unavailable, and that these refusals were communicated to LVNs. However, there was no evidence that a care plan addressing shower refusal was developed until 5/1/2025, despite earlier documentation of refusals and quarterly care plan reviews. Further review indicated that the care planner was not informed of the resident's refusals until months after they began, and acknowledged that a care plan should have been created following the initial interdisciplinary team meeting that documented the refusals. The Director of Nursing confirmed that the resident did not receive showers for two weeks and emphasized the facility's policy of providing showers at least twice weekly, with physician notification required upon refusal. The facility's policy also stated that showers are essential for cleanliness, comfort, and prevention of body odors, and should be offered at least once weekly. The lack of timely care planning and failure to provide scheduled showers resulted in the resident not receiving necessary services to maintain good grooming and personal hygiene.