Failure to Provide Scheduled Showers and ADL Assistance
Penalty
Summary
The facility failed to provide scheduled showers and assistance with activities of daily living (ADLs) for dependent residents, as evidenced by the experiences of three residents. One resident, admitted with multiple diagnoses including weakness, unsteadiness, and osteoarthritis, had physician orders for showers twice weekly. Documentation showed she received only three showers over a two-month period, with the last recorded shower occurring several weeks prior to the survey. There were no documented refusals, and multiple grievances had been filed regarding missed showers for this and other residents. Another resident, with significant medical conditions such as chronic kidney disease, heart failure, and muscle weakness, required substantial to maximum assistance for most cares and had orders for showers twice weekly. Observations revealed the resident was unkempt, with greasy hair, and reported not receiving showers for months due to issues with the shower room environment. Records confirmed only two showers were provided in the previous 30 days. A third resident, who was cognitively intact but required substantial to maximal assistance for bathing and was dependent for toilet hygiene, reported not receiving her preferred weekly bed baths for several weeks, except for one documented refusal. Her care plan indicated a need for frequent incontinence care and regular bed baths, but documentation showed missed care events and lack of follow-up after refusals. Staff interviews confirmed that residents should be checked every two hours and that ADL care is essential for hygiene and dignity, but the records and resident reports indicated these standards were not consistently met.