F0677

E

Failure to Provide and Document Scheduled Showers and Hygiene Assistance

Havana, Illinois Survey Completed on 03-26-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to provide scheduled showers or alternative bathing and to document these services for multiple dependent residents, contrary to its Bathing - Shower and Tub Bath Policy and posted shower schedule. The policy requires that residents be offered a shower, tub bath, or bed/sponge bath according to preference at least twice weekly and as needed, and the shower schedule lists specific days for each resident. For one resident with hemiplegia, chronic pain, dementia, and dependence on staff for bathing and grooming, the Section GG ADL report showed multiple missed scheduled shower days, and the available shower sheets were incomplete and lacked required nurse or DON signatures, including one sheet noting three refusals and pain without complete documentation.

Another resident with Type II DM, stage 4 CKD, asthma, gait and mobility abnormalities, weakness, and an excoriation (skin-picking) disorder had a care plan indicating a need for supervision and assistance with bathing and showering. The GG ADL Lookback report did not show showers on several scheduled days, and only one shower sheet was found for the review period, which was incomplete and unsigned. During observation, this resident was found in bed with a shirt and protective sleeves stained with blood from scabs and reported having received only one shower more than a week prior, stating they did not always get help with showers on scheduled days and felt dirty when showers were missed.

A third resident with hemiplegia, chronic back pain, disability-related activity limitations, and muscle disorder, requiring one to two staff for bathing and grooming, had no documented showers on two scheduled dates, and the DON confirmed that shower sheets for those dates were unavailable. A fourth resident with anemia, schizoaffective disorder bipolar type, morbid obesity, chronic pulmonary embolism, osteoarthritis, overactive bladder, bipolar disorder, major depressive disorder, heart disease, cervical spondylosis, and a history of UTIs had a care plan indicating dependence on staff for bathing and hygiene due to dementia, morbid obesity, and large skin folds. For this resident, there was no documentation of bathing or showers over a 10-day period, and surveyors repeatedly noted a strong, persistent malodorous urine smell in the resident’s room and hallway. This resident reported urinary incontinence, needing help to be changed and cleaned after episodes, not consistently receiving two showers weekly, and not being washed in bed when scheduled showers were missed. The DON confirmed that all residents are scheduled for twice-weekly showers and acknowledged the lack of documentation for the identified dates for all four residents.