Failure to Provide Scheduled Showers and Maintain Resident Hygiene
Penalty
Summary
The deficiency involves the facility’s failure to provide necessary ADL services, specifically bathing and hygiene, to maintain a resident’s grooming and personal hygiene as required by facility policy and the resident’s care plan. The facility’s ADL policy states that residents who cannot independently perform ADLs will receive services to maintain good grooming and personal hygiene, including assistance with bathing, dressing, and grooming in accordance with the plan of care. The resident, who was cognitively intact with a BIMS score of 15 and had diagnoses including dysphagia, cerebral infarction, COPD, CHF, and muscle weakness, required supervision or touching assistance for showering, bathing, dressing, transfers, and walking with a walker, and was care planned to receive supervision or touching assistance by one staff for bathing and moderate assistance for lower body dressing. Despite the care plan and an EMR order for twice-weekly showers, the resident did not receive documented showers on multiple scheduled dates over several months, including numerous missed showers in July, August, September, and October. During an interview, the resident reported not receiving a daily shower and was unable to recall the last shower. On observation, the resident was seen sitting in a recliner wearing personal clothes that were soiled with food stains on the shirt and pants. The DON stated that CNAs are required to complete shower sheets and document refusals, and that these sheets are kept for about one month, but the facility was unable to produce any shower sheets for the resident and acknowledged concerns about the lack of documented showers on the identified dates.
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