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F0677
D

Failure to Provide Scheduled Showers Due to Staffing Shortages

Bonham, Texas Survey Completed on 12-01-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

A deficiency occurred when a female resident with diagnoses including congestive heart failure and schizoaffective disorder, who required substantial assistance with bathing, did not consistently receive scheduled showers on Saturdays. The resident was cognitively intact and her care plan specified that staff were to assist with bathing, particularly washing her back areas. Although the facility's records indicated that all scheduled showers were provided, the resident reported missing showers on Saturdays, attributing this to staff shortages. Multiple staff interviews confirmed that there were frequent staffing shortages, especially on weekends, which led to missed showers for several residents, including this resident. Certified Nursing Assistants (CNAs) and Licensed Vocational Nurses (LVNs) acknowledged that when short-staffed, it was not always possible to provide all required care, including showers. One CNA stated she provided a shower to the resident after the resident reported missing her scheduled shower. Another staff member admitted to not giving any showers on a specific Saturday due to being assigned throughout the building and being short-staffed. The Assistant Director of Nursing (ADON) and Director of Nursing (DON) were aware of the missed showers, with the ADON stating she had completed charting under the impression that showers had been given, though they had not. The DON and Interim Administrator both acknowledged being informed by the resident about missed showers and confirmed that staff were responsible for ensuring showers were provided. The facility's policy required that residents unable to perform activities of daily living independently receive necessary assistance, including with hygiene and bathing.

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