Failure to Provide Scheduled Showers Due to Staffing Shortages
Penalty
Summary
The facility failed to provide scheduled showers in accordance with its Activities of Daily Living, Quality of Care, Routine Resident Monitoring, and Scope of Services policy, which requires monitoring and provision of bathing/showering and personal hygiene. Two residents who were cognitively intact but dependent on staff for ADLs reported missing scheduled showers. One resident, admitted with spinal stenosis, acute kidney failure, and muscle weakness, used a wheelchair for mobility and was dependent on staff for all ADLs; this resident stated he was supposed to receive showers twice a week but had missed some. Another resident, admitted with lack of coordination, generalized muscle weakness, and hypertension, required staff assistance for transfers to the shower/tub and for bathing tasks, and reported missing a couple of showers in the last month. The second resident further stated that in the last month or two he had missed two or more showers and was told by CNAs that staff were not available, that there was construction, and that they did not have enough staff. This resident reported feeling frustrated by missing showers and services and did not want to complain to leadership because staff were busy. A CNA reported being assigned an average of 12 residents on the morning shift and not having enough time to complete all tasks, spending 10 to 45 minutes per resident depending on care needs. An LVN stated that most residents receive showers twice a week and that it is important residents receive showers on their scheduled days as it is their right. The RN supervisor and DON both acknowledged that residents have pre-planned shower schedules, that most residents are dependent on staff for ADLs, and that frequent CNA staffing shortages and sick calls affect residents’ ADL care, contributing to missed scheduled showers for the sampled residents.
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