Failure to Obtain and Honor Resident Bathing Preferences
Penalty
Summary
The deficiency involves the facility’s failure to obtain and honor residents’ bathing and showering preferences, including type, frequency, and time of day, for multiple residents. For one resident with a stroke and right-sided weakness, the admission MDS showed no cognitive impairment and no showers received during the assessment period, and the baseline care plan lacked documentation of daily bathing/showering preferences. The resident’s care plan indicated extensive assistance was needed, yet documentation showed only four showers provided over 26 days. Another resident with dementia and moderately impaired cognition had an MDS indicating it was very important to choose between a shower, tub bath, or bed bath, and the care plan documented a need for maximal assistance. Documentation showed this resident received three showers over 32 days, with one documented refusal. A third resident with multiple sclerosis had a care plan stating they were to be showered twice weekly and as necessary, but documentation over two separate date ranges showed only one shower in 14 days and no showers during an earlier period. A fourth resident with weakness and high blood pressure was dependent for bathing per the admission MDS and required extensive assistance per the Kardex, yet documentation showed only four showers over 22 days. A fifth resident with a stroke and right-sided residual paralysis had an admission MDS indicating it was very important to choose among tub bath, shower, bed bath, or sponge bath, and a care plan documenting extensive assistance with bathing needs, but documentation showed only four showers over 39 days. In an interview, the RN/DON stated residents were showered twice weekly according to a fixed room-based schedule, and that if a shower was refused or not offered, the expectation was that it would be offered the following day, indicating reliance on a set schedule rather than individualized resident bathing preferences.
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