Failure to Provide Scheduled Bathing and Hygiene Services to Dependent Residents
Penalty
Summary
The facility failed to ensure that residents who were unable to carry out activities of daily living (ADLs) received necessary services to maintain grooming and personal hygiene. Specifically, three residents who required substantial or total assistance with bathing did not receive scheduled showers or bed baths on multiple occasions, as documented in their care plans and electronic medical records (EMR). The missed care was not attributed to resident refusals, as there was no documentation of refusals in the progress notes or EMR for these residents, and interviews with the residents confirmed they had not refused care. One resident, a female with a history of pelvic fracture, anemia, and left upper limb nerve lesion, was bedbound and required maximal assistance for bathing. She was frequently incontinent and her care plan specified scheduled bathing three times per week. However, records showed she received only one bath and one documented refusal over a month, missing numerous scheduled baths. She reported to surveyors that staff did not offer her baths and were rude when she requested them. Another resident, a male with heart failure, COPD, quadriplegia, and other chronic conditions, was dependent on staff for all bathing and was always incontinent. His records showed no data for bathing tasks and only two refusals documented in progress notes, despite missing all scheduled baths during the review period. He also reported not receiving scheduled showers and that staff told him they were too busy. A third resident, a female with multiple sclerosis, osteoarthritis, and an indwelling catheter, was dependent on staff for all personal hygiene and had a stage 4 pressure ulcer. Her records indicated only one bed bath documented in the EMR and no refusals, despite missing all other scheduled baths. She stated she received maybe two baths a week and could not recall her last bath. Staff interviews revealed inconsistent knowledge of which residents refused care, and several staff members acknowledged receiving complaints from residents about not getting showers or baths. The facility's policy required documentation of care and refusals in the EMR, but this was not consistently done for the affected residents.