Failure to Provide Ordered Routine Bathing and ADL Assistance
Penalty
Summary
The facility failed to provide routine bathing and personal hygiene care as ordered and care planned for two cognitively intact residents who required assistance with activities of daily living (ADLs). One resident, admitted with diagnoses including muscle weakness and need for personal care assistance, had a care plan indicating self-care deficits and interventions for assistance with grooming and dressing. The MDS showed this resident was dependent for bathing, personal hygiene, and toileting, and physician orders specified showers on Tuesdays and Fridays during day shift. Review of plan of care documentation for several months showed only one documented shower in January, with no showers documented in November or December. During interview, the resident reported having received only two showers since admission and stated that staff instead performed bed wipe-downs and often gave excuses when she requested a shower. A CNA interviewed at the same time stated she was unaware of the resident’s scheduled shower days, though she knew the resident had complained about not receiving showers. A second resident, also with muscle weakness and need for personal care assistance, required moderate assistance with bathing, personal hygiene, and bed mobility and was dependent for transfers. The care plan required assistance with ADLs and allowing extra time to complete them, and physician orders specified showers on Tuesdays and Fridays. Review of documentation for December and into January showed only one documented shower in January and none in December. During interview, this resident reported not being assisted out of bed or given a shower for about a month and stated that since changing rooms, staff told her she was not on a list and therefore had not been gotten out of bed. Observation at the time of interview noted the resident’s hair appeared matted and greasy and the resident had a slight odor. A regional RN confirmed the lack of documented showers for both residents. Facility policy on ADLs required appropriate staff to perform ADL care, including personal hygiene and transferring.
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