Failure to Provide and Document Scheduled Bathing for Multiple Residents
Penalty
Summary
The deficiency involves the facility’s failure to provide and document bathing assistance according to residents’ assessed needs, care plans, and scheduled bathing routines for three residents. One resident with intact cognition and diagnoses including cancer, hypertension, non-Alzheimer’s dementia, anxiety disorder, and schizophrenia was care planned to receive staff assistance with showers/bathing per schedule. Task forms showed this resident received only four baths/showers over a 30-day period, with gaps of 11 days and 7 days between baths. The clinical record did not contain documentation of other attempts to offer or encourage bathing, and the resident’s sister reported that bathing was very infrequent and seemed to occur about every two weeks, often when she was present. A second cognitively intact resident with diagnoses including cancer, hypertension, recent UTI, and chronic kidney disease required setup or cleanup assistance for bathing and was also care planned for scheduled showers/bathing. Task forms showed this resident received four baths/showers over 30 days, with gaps of 5 days and 7 days between baths, and no documentation of additional offers or encouragement for bathing. This resident reported believing she had not had a shower or bath for about two and a half weeks and stated that staff only used wipes to clean her bottom. A third resident with moderately impaired cognition and diagnoses including hypertension, diabetes mellitus, depression, and overactive bladder required substantial/maximal assistance for bathing, preferred showers, and was scheduled for twice-weekly bathing. Task forms showed this resident had a 15-day gap without a bath, and the clinical record lacked documentation of other bathing attempts. This resident reported liking whirlpool baths, described the shower as gross, and stated he received a bath about once a week but would like more frequent baths. The DON and Administrator reported that baths are scheduled twice weekly and documented in the electronic record, and the DON acknowledged concerns with bathing documentation and lack of insight into why baths were not done, while facility policy required documentation of completed showers/baths in point-of-care charting.
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