Failure to Follow Care Plan for Bathing Method
Penalty
Summary
The facility failed to ensure a resident received care in accordance with physician orders and the individualized care plan regarding bathing method. The resident was admitted with vesicointestinal and colovaginal fistulas and had an Activities of Daily Living (ADL) care plan and Kardex, both initiated on 07/21/2025, specifying that the resident was to receive only showers due to their urinary and gastrointestinal fistulas. The admission MDS dated 07/27/2025 documented a BIMS score of 09, indicating moderate cognitive impairment. Despite these documented directives, review of the NAC documentation for August 2025 showed that on 08/21/2025 the resident received a bath. During interviews, the NAC who provided care stated they reviewed the care plan and Kardex to determine the type of care and assistance needed and acknowledged that the documentation code for a shower was different from that for a bath. The NAC confirmed documenting that the resident received a bath on 08/21/2025. The RN/DNS stated that care plans are used to ensure staff know how to provide residents’ personal care and that staff were expected to follow the care plan and not give baths when only showers were ordered. The surveyors concluded that the facility did not provide care according to the resident’s orders and care plan, as required by WAC 388-97-1060(1)(2)(c).
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