Failure to Provide Scheduled Showers Due to Staffing Shortages
Penalty
Summary
The facility failed to ensure that residents who required assistance with activities of daily living, specifically bathing or showers, consistently received this care as scheduled. Four residents with varying degrees of cognitive and physical impairment were identified as not receiving showers according to the facility's established schedule. Documentation and interviews revealed that showers were missed on multiple occasions for these residents, with gaps in the shower review sheets indicating that the care was not provided as required. Residents affected included individuals with significant medical histories such as diabetes, chronic obstructive pulmonary disease, pressure ulcers, hemiplegia, and severe cognitive impairment. These residents were documented as dependent or requiring substantial assistance for bathing. Interviews with the residents, a family member, and multiple CNAs confirmed that showers were often missed, and the lack of consistent care was attributed to frequent staffing shortages. Residents and family members expressed concerns about the infrequency of showers, and staff reported difficulty in completing all required showers due to insufficient staffing levels. The facility did not have a policy on bathing or showers, as confirmed by the administrator. The assistant director of nursing was unable to provide additional documentation to show that showers were completed on the missing dates, indicating that the care was likely not provided. The lack of documentation and staff statements further supported the finding that the facility failed to provide necessary assistance with bathing for residents who were unable to perform this activity independently.