Failure to Provide Regular Showers and ADL Assistance
Penalty
Summary
The facility failed to provide regular showers and adequate assistance with activities of daily living (ADLs) for 10 out of 18 sampled residents who were unable to perform these tasks independently. Observations and interviews revealed that multiple residents appeared unkempt, with oily or matted hair, and expressed feelings of being dirty or neglected due to missed or infrequent bathing. Shower logs confirmed significant gaps between baths, with some residents going up to 16 days or more without a shower, and in one case, a resident did not receive any bath in a 30-day period. Residents' care plans consistently indicated the need for staff assistance with bathing due to various medical conditions such as decreased mobility, Parkinson's disease, stroke, and memory deficits. Several residents and their families reported concerns about hygiene and the lack of regular bathing. For example, one resident stated that staff refused to help with baths, resulting in missed showers and feelings of being dirty. Another resident's family contacted the facility to express concern about the resident's matted hair and infrequent bathing. Residents' care plans outlined specific interventions, such as offering bed baths if showers were declined and notifying nursing staff if both were refused, but documentation and interviews indicated these interventions were not consistently implemented. A review of the facility's Quality Assurance and Performance Improvement (QAPI) Performance Improvement Project (PIP) action plan identified issues with staffing, adherence to bathing schedules, and documentation as root causes for the deficiency. Despite recognizing the problem, the facility did not follow through with corrective actions, as evidenced by ongoing missed or delayed showers for multiple residents. Facility policy required that care and services for ADLs, including bathing, be provided based on comprehensive assessment and resident needs, but this standard was not met for the affected residents.