F0677

D

Failure to Consistently Provide and Document Scheduled Resident Bathing

Urbandale, Iowa Survey Completed on 02-11-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to consistently offer and provide scheduled bathing assistance to dependent residents, despite care plans and schedules indicating the need for regular showers or baths. Resident #5, who had intact cognition with a BIMS score of 15 and diagnoses including arthritis, chronic pain syndrome, and heart failure, required staff assistance with bathing and showers per the care plan. Documentation for December and January showed that bathing was scheduled twice weekly on Tuesdays and Fridays, but in December baths were documented as completed only four out of nine scheduled days, and in January only two out of nine scheduled days. There was no documentation for the remaining scheduled bath days to indicate whether bathing was completed, not offered, or refused. Resident #5 reported going over two weeks between showers, stated that baths or showers were often not offered, and noted having to ask for a shower, particularly during January.

Resident #3, admitted with osteoporosis and major depressive disorder and dependent on staff for bathing, also had a BIMS score of 15 indicating no cognitive impairment. According to a family member interview, the resident did not receive a first shower until 19 days after admission, and after that first shower, the family was told the resident would receive showers twice weekly. However, the family member reported the resident went eight days before the next shower and received only two showers in a 30‑day period. Documentation Survey Reports for showers covering December and January confirmed that from 12/17/25 to 1/17/25, the resident received showers only on 12/31/25 and 1/8/26.

Resident #1, who had intact cognition with a BIMS score of 15 and was dependent on staff for transfers and bathing, had a care plan identifying an ADL self‑care performance deficit related to pain and impaired balance and mobility, with staff directed to provide assistance of one for bathing. The bath schedule showed this resident’s room was assigned baths on Tuesday and Friday mornings. Review of paper bath sheets and Documentation Survey Reports from November through January revealed that baths were documented as completed on only a small fraction of the scheduled bath days: two of nine in November, one of nine in December, and two of nine in January, with one documented refusal and one missed bath due to hospitalization. Multiple staff interviews confirmed that CNAs were responsible for baths, used room‑based bath schedules, and were expected to document in both paper bath sheets and the computer, but staff acknowledged that paper bath sheets frequently were not completed. The DON and other staff described prior lack of a clear process and issues with scheduling and documentation of baths, while the facility’s ADL policy required that residents unable to carry out ADLs independently receive services necessary to maintain good grooming and personal hygiene, including bathing.