Failure to Provide Scheduled Bathing Assistance per Resident Preference and Care Plan
Penalty
Summary
The deficiency involves the facility’s failure to provide assistance with activities of daily living (ADLs), specifically bathing, to a resident who was dependent on staff for bathing and had a stated preference for showers twice weekly on Tuesdays and Fridays. The resident reported very rarely receiving two showers per week and stated she did not feel clean due to the lack of showers. Review of the resident’s care plan dated 1/21/26 showed she was dependent on staff for bathing with assistance of one staff member. Review of bathing records from 12/1/25 through 2/26/26 showed the resident was scheduled for showers twice weekly but did not receive scheduled showers on multiple dates, resulting in 17 showers out of 24 opportunities over three months. The electronic medical record showed the resident went without a shower for more than six days on four occasions and once for 13 days between showers, supporting the resident’s claim of not receiving the preferred two showers per week. Staff interviews revealed that CNAs relied on shower schedules and a list at the nurse’s station to determine which residents were to receive showers, and that refusals were to be re-approached and, if persistent, documented on a shower refusal form with the resident’s signature. One staff member stated she was unsure if residents scheduled for evening showers had been completed and noted that residents scheduled for evening showers often requested showers the following day. Another staff member stated that if a resident refused a shower, a different CNA would offer it, and if refusal continued, a refusal sheet would be completed and signed by the resident. When the shower refusal notebook at the nursing station was checked, only one refusal form was present. The facility’s ADL policy dated 9/8/25 stated that residents receive assistance with ADLs, including hygiene and bathing, based on individual needs, preferences, and care plan goals, and that ADL assistance and resident response are documented in the medical record, but the documented shower frequency for this resident did not align with her care plan and stated preferences.
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