Failure to Provide and Document Regular Bathing for Dependent Residents
Penalty
Summary
The deficiency involves the facility’s failure to provide and document weekly bathing or showers for dependent residents, as required by resident care plans and facility policy. One resident with intact cognition, respiratory failure, heart failure, morbid obesity with hypoventilation, and an MRSA infection required partial to moderate staff assistance with bathing and had a care plan directing staff to assist with baths or showers per schedule. This resident filed a grievance stating she was not getting showers and reported not having received one in a week. Electronic health records for the month reviewed showed only one documented shower and one refusal, with no other baths or showers recorded, despite the resident’s expressed concerns. Another resident with moderately impaired decision-making, myotonic muscular dystrophy, diabetes mellitus, and malnutrition also required assistance with ADLs and had a care plan directing staff to assist with scheduled baths or showers, later updated to note a preference for bed baths while still requiring staff to offer showers. For this resident, documentation for the month showed only one shower provided, multiple refusals, several days left blank, and several days explicitly documented as no shower given. Staff interviews revealed that since a decreased staff-to-resident ratio was implemented, residents had not been receiving showers, and staff reported residents going a week or more without a shower. The DON acknowledged that completion of resident baths and showers needed improvement and stated the expectation was two baths or showers per week, while facility policy required staff to document completed baths and showers in the EHR.
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