Failure to Provide Adequate Bathing and Timely Incontinence Care
Penalty
Summary
The deficiency involves the facility’s failure to provide adequate assistance with activities of daily living (ADLs), specifically bathing and timely incontinence care, for one resident. The resident was admitted and later readmitted with hemiplegia and hemiparesis following a cerebral infarction affecting the left non-dominant side, and had a BIMS score indicating moderate cognitive impairment, yet was able to converse and answer questions appropriately. The resident reported going days without showers, disliking the resulting body odor, and stated a preference for two showers per week with additional showers as needed. The task list reflected this preference for showers twice weekly and PRN. However, record review showed the resident received only bed baths on two dates in February and did not receive a first shower until several weeks after admission, with the next shower not occurring until early March. There were no documented shower refusals in the electronic medical record. The deficiency also includes failure to provide timely incontinence care. A progress note documented that on one morning in February the resident and bed were soiled with urine while the resident was in bed requesting to get out of bed. Therapy staff reported finding the resident “pretty saturated in urine,” with urine soaking through clothing, bed linens, and down to the mattress, and they notified nursing and assisted with incontinence care. An LPN confirmed entering the room that morning to assist therapy staff and verified that the resident was saturated in urine through clothing and bed linens. These findings occurred despite a facility policy on ADLs stating that appropriate care and services, including support and assistance with hygiene (bathing) and elimination (toileting), would be provided for residents unable to carry out ADLs independently.
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