Failure to Provide Scheduled Showers and Hygiene Assistance
Penalty
Summary
The facility failed to ensure that residents received showers as scheduled, as evidenced by record reviews, interviews, and policy review. Seven residents who required assistance with activities of daily living (ADL) did not consistently receive showers according to their individualized care plans and the facility's shower schedule. Documentation showed missed or rescheduled showers, and in several cases, there was no evidence that alternative hygiene measures, such as bed baths, were offered or provided after a shower was refused or missed. Residents affected had a range of medical conditions, including dementia, urinary incontinence, emphysema, systemic lupus erythematosus, muscle weakness, schizoaffective disorder, diabetes, aphasia, hemiplegia, depression, multiple sclerosis, and other chronic illnesses. Many were cognitively intact and expressed the importance of choosing their bathing method. Care plans and MDS assessments indicated varying levels of assistance required, from partial to total dependence on staff for bathing. Despite these documented needs and preferences, the facility did not consistently follow through with scheduled showers or provide appropriate alternatives when showers were missed or refused. Interviews with residents, CNAs, LPNs, and the Administrator confirmed the inconsistency in providing scheduled showers. Staff reported being unable to complete all assigned showers, sometimes due to the absence of a dedicated shower aide. Facility policy required documentation of showers or baths, including refusals and interventions taken, but records often lacked evidence of follow-up or alternative hygiene care. The deficiency was identified during a complaint investigation and had the potential to affect additional residents who were dependent on staff for bathing.