Failure to Provide Scheduled Showers and Document ADL Care
Penalty
Summary
A deficiency was identified when a resident who required assistance with activities of daily living (ADLs), including bathing, did not receive showers as scheduled. The resident, an elderly female with diagnoses including a need for personal care assistance, lack of coordination, cognitive communication deficit, major depressive disorder, and hypertension, was assessed as needing partial to moderate assistance with showers. Her care plan specified that she should receive limited to extensive assistance with bathing or showers as necessary, with a scheduled frequency of three times per week. Record reviews revealed that during the month in question, only three showers were documented for the resident, despite a schedule of showers on Mondays, Wednesdays, and Fridays. There were no documented refusals of showers, and the resident's care plan did not address any behaviors related to refusing care. Interviews with the resident confirmed that she was aware of her shower schedule but reported not receiving showers as expected and not being able to recall when her last shower occurred. She stated that when she requested a shower after a missed session, she was told she might be fit in if there was a cancellation, but this did not occur. Staff interviews indicated that showers were to be provided and documented by CNAs, with refusals also to be recorded. The DON and ADM both confirmed that the expectation was for showers to be provided and documented as scheduled, and that there were no known refusals or behaviors preventing the resident from receiving care. The facility's shower policy required documentation of showers and refusals, as well as monitoring for compliance. The lack of documentation and provision of scheduled showers for the resident constituted a failure to ensure necessary services for maintaining personal hygiene.