Failure to Provide Scheduled Showers and Honor Bathing Preferences
Penalty
Summary
The deficiency involves the facility’s failure to provide scheduled showers or baths and to honor bathing preferences for three residents who required staff assistance with activities of daily living. One resident with hemiplegia and intact cognition was dependent on staff for showers and was scheduled for a weekly bath on Tuesdays. Review of the Medication Administration Record (MAR) showed multiple Tuesdays over several months with blank documentation for the ordered weekly skin check and bath, and the facility could not produce complete bath schedules for parts of November and December. The resident reported wanting showers, stated they had not received showers on recent scheduled days, and denied refusing showers, while a family member confirmed the resident had complained about not receiving showers, particularly in November and December. Another resident with complete paraplegia, obesity class 3, neurogenic bowel and bladder, and intact cognition had an order for a weekly skin check and bath according to the shower schedule. The Treatment Administration Record (TAR) showed the order documented as completed on three dates, but the facility did not have a functioning bariatric shower chair during the resident’s stay. The scheduler/central supply staff member stated a bariatric shower chair was ordered the day before admission after being informed of the need, that the existing bariatric chair was found to be nonfunctional and could not be repaired by maintenance, and that the replacement chair did not arrive until after the resident was discharged. An RN stated that the resident’s scheduled “shower” would have been provided as a bed bath due to the lack of a working bariatric shower chair. A third resident with moderate cognitive impairment and an activated POA was dependent on staff for bathing and expressed a clear preference for showers over bed baths. The resident reported that staff did not ask about bathing preference and instead provided bed baths, stating they wanted only showers and were bothered by not receiving them. The DON stated that showers and baths are documented on the MAR or TAR, that refusals and reasons should be documented, and that blanks should not be left because they indicate a shower or bath was not completed. The DON and an LPN both indicated that a checked MAR/TAR entry signifies that a shower/bath and skin check were completed, and that blank entries mean the care was not done, confirming that scheduled showers/baths and resident preferences were not consistently honored or documented for these residents.
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