Failure to Provide Scheduled Showers and ADL Assistance for Hygiene
Penalty
Summary
The deficiency involves the facility’s failure to provide appropriate ADL care, specifically showers, to maintain a resident’s personal hygiene as required by her care needs and facility policy. Record review showed that a cognitively intact female resident, admitted from an acute care hospital with multiple complex medical conditions including heart failure, kidney failure, diabetes, cerebrovascular accident, depression, and frequent bowel and bladder incontinence, required set-up or clean-up assistance with personal hygiene and supervisory assistance with showers/baths. Her admission MDS documented that she was independent with eating, oral hygiene, and upper body dressing, but needed assistance for personal hygiene and bathing. Review of her electronic medical record over a 20‑day look‑back period showed that showers on two specific dates were documented as “not applicable,” and there was no documentation of a shower over a three‑day span. During interview, the resident reported that earlier in the month she went multiple days without a shower because the CNA assigned to her stated she would provide the shower at the end of the shift, then later reported she had run out of time and did not provide the shower or offer an alternative opportunity. The resident stated she did not refuse care, did not report the missed showers to nursing, and felt unclean after going three days without a shower, expecting to receive one every other day. CNA A confirmed that the resident’s shower days were Monday, Wednesday, and Friday, and admitted that on the days documented as “not applicable” she simply ran out of time, despite having enough staff, and did not coordinate with other staff or notify the nurse. Facility leadership interviews confirmed that residents were expected to receive showers at least twice weekly according to their care plan and that the resident should have been offered showers on her scheduled days, consistent with the facility’s Bath and Resident Rights policies, which state that residents will receive assistance with bathing per their care plan and have a right to a dignified existence.
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