Failure to Consistently Offer and Document Scheduled Showers for Dependent Residents
Penalty
Summary
The deficiency involves the facility’s failure to consistently offer and provide showers to residents who required assistance with activities of daily living, as well as failure to consistently document showers, bed baths, and refusals, contrary to facility policy. One resident with dementia, severe cognitive impairment, and multiple medical conditions including a left femur fracture, heart disease, hypertension, kidney disease, and a history of falls was care planned to receive substantial to maximum assistance with showering or bathing and was scheduled for showers twice weekly. Review of shower records over a two‑month period showed he received only one shower and several bed baths, with a few documented refusals, indicating that showers were not provided as scheduled. The facility’s bathing policy required honoring bathing preferences, providing showers twice weekly, and documenting refusals with nurse notification. Another resident, cognitively intact with diagnoses including diabetes, chronic bronchitis, hyperlipidemia, and sleep apnea, was also care planned for substantial to maximum assistance with showering or bathing and scheduled for showers twice weekly. Review of his shower sheets for the same period showed he received only one shower and several bed baths, with multiple documented refusals, and he reported in an interview that he was never offered a shower. A CNA stated that when a resident refused a shower, a bed bath would be offered instead. The Administrator confirmed that showers, bed baths, and refusals were not consistently provided to or documented for these residents, demonstrating noncompliance with the facility’s own bathing policy.
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