Insufficient Staffing Leads to Delays in Resident Bathing
Penalty
Summary
The facility failed to provide sufficient numbers of direct care staff to ensure timely assistance with baths and showers for all residents, as evidenced by observations, interviews, and record reviews. The facility had a policy requiring showers to be given as scheduled and/or as needed, and residents were not to be left alone in the shower room. However, after the removal of two dedicated Shower Aides from daily assignments, residents experienced significant delays in receiving their scheduled baths and showers, with some waiting in excess of two to three hours. Multiple residents were observed waiting in wheelchairs outside the bath/shower room for extended periods, and several reported missing activities or having to clean themselves due to the lack of available staff. Residents affected included individuals with complex medical needs, such as one with chronic skin conditions requiring daily bathing to prevent infection and control odor, and others with severe morbid obesity, congestive heart failure, and mobility impairments. These residents were assessed as requiring varying levels of staff assistance for activities of daily living, including bathing. Despite their care plans indicating the need for staff support, residents consistently reported long wait times and unmet needs following the staffing change. Resident council meeting minutes and direct interviews confirmed that the new process was not working, and residents' preferences and schedules for bathing were not being honored. Staff interviews corroborated the residents' accounts, with CNAs reporting increased workloads after being reassigned from dedicated shower duties to broader floor responsibilities. CNAs described being responsible for large numbers of residents, many of whom required two-person assistance, frequent turning, repositioning, and incontinence care, making it difficult or impossible to provide timely baths and showers. Facility leadership acknowledged the recent system change and the resulting delays, stating that the facility was still working out issues with the new staffing model, but confirmed that residents' needs were not being met in a timely manner.