Failure to Provide and Document Scheduled Showers and Hygiene Care
Penalty
Summary
The facility failed to provide scheduled shower services and to maintain grooming and personal hygiene for one of three sampled residents. The resident had an admission MDS dated 12/2/25 showing a BIMS score of 09, indicating moderately impaired mental status, and required maximal assistance for showers, with the helper performing more than half of the effort, including lifting and holding the trunk or limbs. The resident’s diagnoses included traumatic brain injury and hemiplegia/hemiparesis related to stroke. The facility’s AM Shift Shower Schedule, dated 5/2020, indicated the resident was to receive showers twice weekly on Wednesdays and Saturdays. A review of the Documentation Survey Report for December 2025 showed the resident did not receive showers on 12/6/25, 12/13/25, 12/17/25, and 12/24/25, despite being scheduled. CNA 1 stated that the facility process was to provide showers as scheduled, complete shower sheets, document refusals, and notify the charge nurse. The DON confirmed that staff were expected to offer showers twice weekly and, if refused, to notify the charge nurse and document the refusal in the resident’s record. The DON was unable to provide documentation that showers were offered as scheduled or that refusals and notifications were recorded. The facility’s policy on Bath, Shower/Tub, revised February 2018, required documentation of refusals, reasons, interventions taken, the signature and title of the person recording, and notification of the supervisor and physician as appropriate.
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