Failure to Provide Scheduled Bathing Assistance for Dependent Resident
Penalty
Summary
The deficiency involves the facility’s failure to provide scheduled and needed bathing assistance for a dependent resident in accordance with the facility’s Activities of Daily Living policy and the resident’s care plan. The policy required the facility to provide care and services for bathing based on the comprehensive assessment and to ensure residents who are unable to carry out ADLs receive necessary services to maintain grooming and personal hygiene. The resident’s care plan documented self-care deficits in ADLs, with goals for the resident to remain neat, clean, odor-free, and dignified, and specified that bathing and showering were to be completed per facility policy and as needed. The resident, who was admitted with impaired coordination, abnormal gait, difficulty walking, generalized muscle weakness, muscle spasms, morbid obesity, and complete bowel and bladder incontinence, was assessed on the MDS as having little to no cognitive impairment but significant functional limitations. The MDS showed the resident required substantial to maximal assistance with eating and was dependent on staff for oral hygiene, toileting hygiene, showering/bathing, dressing, and personal hygiene. The care plan required use of a Hoyer lift with two staff for transfers and indicated that bathing and showering, including regular shampooing and nail care, were to be provided per policy. The EMR task list specified that the resident was to receive bathing on Tuesday, Thursday, Saturday, and PRN. Surveyor observations and interviews showed that the resident expected a shower on a scheduled shower day but reported the next morning that the shower had not been provided and that scheduled showers were frequently missed despite her and her family’s reports of concern. The resident’s POA expressed dissatisfaction, stating that insufficient staffing resulted in the resident not being bathed regularly. The shower team CNA reported she did not have enough time to complete all scheduled showers and that other CNAs were expected to complete remaining showers, with documentation on paper shower sheets. Another CNA stated she was unsure whether the resident had received a shower and confirmed that if the shower CNA could not complete all showers, other staff were expected to do so. Review of available shower sheets and EMR records for the prior two months showed the resident received only five showers in February and three in March through mid-month, significantly fewer than the three-times-per-week schedule. The DON acknowledged the facility strives for three showers per week but was unable to explain why the resident received fewer showers than scheduled.
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.