Failure to Provide Assisted Grooming and Shaving With Scheduled Showers
Penalty
Summary
Surveyors identified that a resident who was cognitively impaired and dependent on staff for toileting, hygiene, and bathing was not provided grooming services to maintain personal hygiene. The resident had been admitted with a hip fracture and had a BIMS score of 03, indicating impaired mental status and inability to recall the correct year, month, and day of the week. The resident’s MDS documented that she required maximal assistance with showering/bathing and assistance of two or more helpers with toileting and hygiene. During observation, the resident was seen sitting in a wheelchair next to her bed with visible facial hair around her chin. The resident stated she had previously asked staff for a shave and that she wanted to be shaved. CNA 1 reported that residents’ facial hair was supposed to be shaved during scheduled showers but could not explain why this resident had not been shaved. Review of the resident’s Shower Day Skin Inspection forms on multiple dates showed that the resident had facial hair documented on each occasion, indicating the condition was ongoing. The DON stated that the facility’s expectation was that CNAs offer shaving with scheduled showers after obtaining consent, and that refusals should be reported to the charge nurse and documented. The facility’s shower policy required showers at least twice weekly, documentation of showers on the ADL flow sheet, and involvement of nursing and social services if residents continually refused bathing, with care plan interventions to address the situation. Despite these expectations and policies, the resident’s facial hair remained unshaven over multiple shower days.
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