Failure to Provide Scheduled Showers and Document Hygiene Care
Penalty
Summary
A deficiency was identified when a resident who was dependent on staff for activities of daily living, including bathing, did not receive showers according to her scheduled shower days. The resident, who was admitted following ankle surgery and was non-weight bearing, required substantial to maximal assistance for bathing and was coded as dependent for tub/shower transfers. Review of her care plan showed interventions to keep her skin clean and dry due to surgical wounds, but there were no specific entries addressing bathing or hygiene. Electronic medical records indicated that the resident missed scheduled showers on three occasions, and there were no progress notes documenting reasons for these missed showers. Interviews with family members and the resident revealed that showers were not consistently provided as scheduled, and staff often did not ask the resident if she wanted a bath. Family members reported having to prompt staff to provide bathing, and the resident recalled only one instance of refusing a bath, which was not on one of the missed dates. The Director of Nursing (DON) and Administrator confirmed that it was the responsibility of nursing staff to ensure showers were given per schedule and that refusals should be documented, but there was no evidence of such documentation for the missed showers. Facility policy required documentation of showers, refusals, and any interventions taken, as well as notification of supervisors if a resident refused a shower. The lack of documentation and failure to provide scheduled showers represented a failure to ensure necessary services for maintaining personal hygiene for a resident unable to perform these activities independently.