Failure to Provide Required Bathing and Personal Hygiene Assistance
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs), specifically bathing and personal hygiene, to a resident who required help. Facility policy required that residents unable to perform ADLs receive needed assistance and that any change in ADL ability be reported to nursing, ensuring residents maintained good grooming and personal hygiene. The resident’s MDS documented mild cognitive impairment, no behaviors, and a need for partial/moderate assistance with showering/bathing and supervision or touching assistance with personal hygiene. The care plan in effect identified an ADL self-care performance deficit related to impaired balance, limited mobility, and pain, and directed staff to provide moderate assistance for bathing at least twice weekly and as necessary, along with personal assistance for hygiene. The resident’s diagnoses included hidradenitis suppurativa with painful boils on the buttocks and around the anus, muscle weakness, and cancer. The shower calendar showed only five showers or bed baths documented from admission through mid-January, despite the care plan requirement. During multiple observations over several days, the resident was repeatedly found lying in bed on their stomach with matted, unkempt hair and a persistent odor of bowel movement in the room. The resident reported significant pain from boils that leaked and caused odor and discomfort, stated they had not had a shower since admission, and consistently reported not being offered showers or bed baths, including after wound treatments when only the wound area was cleansed. Staff interviews confirmed that the resident needed assistance with showers or bed baths and that facility practice was to offer two showers per week. A CNA acknowledged the resident needed hair washed and treated and that staff were expected to offer two showers weekly. Another CNA, assigned to the resident, stated the resident was scheduled for showers on specific days and was not due for a shower on the day in question, and made a remark about the resident’s hair, saying the resident “has an afro” and questioning expectations, adding that if the resident wanted hair washed, they would wash it. An RN confirmed the resident needed assistance with showers and personal care and that hair care was part of shower or bed bath, but was unsure what was being done about the resident’s hair. Facility leadership stated the resident should have received at least two showers per week, including hair washing if requested, indicating that the resident’s documented needs and care plan interventions for ADL assistance, bathing frequency, and hair care were not consistently implemented.
We Help Long-Term Care Teams Stay Survey-Ready
We process and analyze inspection reports and plan of correction using AI to extract insights and trends so providers can improve care quality and stay ahead of compliance risks.