F0550

D

Failure to Honor Resident’s Refusal of Shower and Right to Dignified Care

Livonia, Michigan Survey Completed on 02-26-2026

Penalty

No penalty information released

Summary

Surveyors identified a failure to honor a resident’s right to refuse care and to be treated with dignity when staff proceeded with a shower despite the resident’s verbal refusals. The resident, who had Down Syndrome, major depressive disorder, moderate intellectual disabilities, a BIMS score of 3/15 indicating severely impaired cognition, and a documented history of refusing showers/ADLs, was the subject of a complaint alleging they were forced to shower. According to the facility’s investigation, the CNA assigned to the resident requested assistance from another CNA. The assigned CNA reported hearing the resident say, "I don't want to take a shower; I don't want to take a shower," and heard the assisting CNA respond, "you're going to take this shower." Another CNA, who was nearby, also reported hearing the resident repeatedly say "No shower" and a CNA telling the resident, "you are going to take a shower."

The investigation further documented that the assisting CNA stated the shower was already running and spraying water on the resident when they entered the shower room, and that the resident left the shower room and walked to their room with wet clothes on before staff could assist. The assigned CNA reported returning to the shower room and observing the resident wearing wet clothes with soap on their face. An LPN reported being told by the assigned CNA that the assisting CNA had started wetting the resident while the resident’s clothes were still on, and the LPN observed the resident in the shower room with clothes still on, a soiled shirt on the floor, and the resident at the sink with their pants down. The facility’s resident rights policy states that residents have the right to a dignified existence, self-determination, and to make choices about schedules and care, including the right to refuse showers or care.