Failure to Honor Resident Choice for Daytime Showers
Penalty
Summary
The facility failed to honor a resident’s right to make choices about significant aspects of her daily life, specifically her bathing schedule. A female resident with early-onset Alzheimer’s disease, severe cognitive impairment (BIMS score of 3), muscle weakness, gait and mobility abnormalities, lack of coordination, and hypertension was dependent on staff for showering and bathing. Her comprehensive care plan identified a self-care deficit and need for staff assistance with showering but did not document her shower preferences. Facility shower assignment records showed she was scheduled for showers on the 6 p.m.–6 a.m. shift three days per week, and during the review period she received bed baths late at night between approximately 10:18 p.m. and 11:39 p.m. instead of showers. The resident’s family member reported that over the last month the resident had missed several showers because the aide arrived so late in the evening that the resident was already ready to stay in bed, resulting in bed baths being provided instead of showers. The family member stated the resident’s hair had not been washed in over two weeks due to receiving bed baths rather than showers. The family member also reported that they had requested multiple times that the resident’s scheduled shower time be moved to the day shift, and that the ADON and DON responded they would try to provide day-shift showers if time allowed, otherwise the resident would continue to receive showers in the evening. Observation of the resident showed her hair was greasy, limp, and clumped together. Staff interviews confirmed awareness of the family’s request and the facility’s reliance on a standardized bathing schedule based on room location and hall assignment. CNA A stated that the resident’s family wanted the resident to be first on the 6 p.m. shift, but due to the shower schedule, the resident’s end of the hall was typically reached around 11 p.m., and that although residents should receive showers at their requested times, not everyone could have a day-shift shower. The DON acknowledged knowing of the family’s request for day-shift showers but stated the facility followed a standard bath schedule by hall and did not offer to move the resident to a different hall to accommodate the request. The ADON similarly stated that the facility used a standardized bathing schedule based on room location and that, due to this, the resident was showered on the night shift, with some showers provided during the day only when day-shift staff were able. The Administrator stated that if a family requested a day-shift shower, it should be person-centered and scheduled during the day, and that honoring residents’ choices was important, but she was not aware of this specific request.
We Help Long-Term Care Teams Stay Survey-Ready
We process and analyze inspection reports and plan of correction using AI to extract insights and trends so providers can improve care quality and stay ahead of compliance risks.