F0677

D

Failure to Provide and Document Scheduled Bathing and ADL Care

Marietta, Georgia Survey Completed on 02-18-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to provide and document bathing and ADL care according to residents’ needs and the facility’s own shower schedule and policy. One resident, R15, reported during an interview that she had not received a shower since admission, although she had received bed baths and preferred showers. Her admission MDS showed she was cognitively intact, dependent for bathing, and had impaired lower extremity mobility, with a care plan indicating she required assistance of two staff for bath/shower and transfers, and noted a preference for bed baths. The bath schedule assigned her room showers twice weekly on the evening shift, but review of February bath sheets showed only one shower documented out of four scheduled dates, and no bath sheet for a specific scheduled date, while she stated that staff did not ask her about taking a shower when a new roommate was offered one.

A second resident, R46, also did not receive showers and related ADL care as scheduled and documented. She was cognitively intact, dependent on staff for oral hygiene, toileting hygiene, and showering/bathing, with a care plan identifying ADL self-care deficits and requiring two staff for bathing/showering, including provision of sponge baths if a full bath or shower could not be tolerated. Observation found her in bed with oily hair, and she stated she had not had a shower. Her family representative reported that her hair appeared never shampooed and her teeth appeared caked with debris, and that leadership, including the DON and Social Worker Director, had been informed. The bath schedule assigned her room showers twice weekly on day shift, but February bath sheets only showed dates without indicating what type of bathing was provided, and an LPN confirmed that only two shower sheets were present when six should have been, with no documentation of refusals.

A third resident, R125, similarly did not receive or have documented twice-weekly bathing as required. He was cognitively intact with multiple significant diagnoses, including bilateral above-knee amputations, morbid obesity, heart disease, chronic kidney disease, and an unstageable sacral pressure ulcer, and was dependent on staff for oral hygiene, toileting, showers, dressing, and personal hygiene. Review of shower sheets over three months showed very few bath sheets compared to the expected number based on a twice-weekly schedule. During observation and interview, there was a very strong body odor noted, and both he and his roommate reported that baths were not provided consistently and less than twice weekly; he stated he only takes bed baths due to orthostatic hypotension and feeling unsafe sitting up, that he occasionally refuses when not feeling well, and that staff had stopped offering baths regularly. Staff interviews with a CNA, an LPN, and the DON confirmed that all residents are scheduled for two baths per week, that a bath/shower sheet should be completed for every scheduled bath including refusals, and that this documentation was not present for R125, indicating that required offers and/or provision of bathing were not consistently carried out or recorded for these residents.