Failure to Provide Scheduled Showers and Adequate Bathing Assistance
Penalty
Summary
Surveyors identified that the facility failed to provide showers as required for three residents who were dependent on staff for activities of daily living (ADLs), specifically bathing. Facility policy required that residents unable to perform ADLs independently receive necessary services to maintain personal hygiene, including scheduled showers or alternative bathing methods. However, documentation and staff interviews revealed that these residents did not consistently receive showers as scheduled, and in some cases, only bed baths were provided without documented alternatives or clear communication in care plans. One resident with hemiplegia, hemiparesis, seizures, and dementia was completely dependent on staff for all care, including bathing. Despite care plans and physician orders specifying scheduled showers, the resident only received bed baths due to poor trunk control and lack of appropriate equipment, such as a shower cot. The facility did not provide alternative bathing methods or update care documentation to reflect the resident's actual bathing routine. Bathing records showed multiple missed scheduled bathings, with the resident sometimes going up to ten days without a bath. Another resident, cognitively intact but requiring maximum assistance for bathing, was scheduled for showers twice weekly. However, review of records and staff interviews indicated that showers were often not provided as scheduled, particularly on certain days when staff expressed reluctance or cited the absence of therapy staff. The third resident, with multiple chronic conditions and mobility impairments, was also scheduled for showers twice weekly but reportedly never received a shower since admission due to lack of appropriately sized equipment. Staff documented showers in records despite only providing bed baths, and the resident reported never having their hair washed by staff. Facility leadership and staff confirmed the lack of appropriate equipment and the absence of consistent documentation or alternative bathing arrangements.