Insufficient Staffing Resulting in Missed Scheduled Showers
Penalty
Summary
The deficiency involves the facility’s failure to provide sufficient nursing staff to meet residents’ activities of daily living (ADL) needs, specifically bathing, for three cognitively intact residents who required staff assistance. One resident with respiratory failure and chronic kidney disease required substantial/maximal assistance with bathing and was dependent on staff for transfers to the shower, with showers scheduled twice weekly. Electronic health record (EHR) documentation showed only one shower provided over a period of more than a month, and the resident reported not having had a bath in over a week. A certified nursing assistant (CNA) confirmed they were responsible for the resident’s bath on a specific day but did not complete it due to lack of time during the shift. A second resident, who required partial/moderate assistance with bathing and was scheduled for twice-weekly showers, received only three showers out of seven scheduled opportunities in one month and reported usually receiving only one shower per week. A third resident, who required substantial/maximal assistance with bathing and was also scheduled for twice-weekly showers, received only three showers out of eight scheduled opportunities in the same month and reported that showers were not being given as often as they should be. Multiple CNAs stated that residents were supposed to receive two showers per week but that showers were often not completed because the facility was short staffed or there was not enough time in their shifts to complete all assigned showers. One CNA reported being assigned six showers on a shift but completing only two. An LPN stated the charge nurse was responsible for ensuring showers were given and that incomplete showers should be passed to the night shift, and the DON acknowledged there had been staffing issues, though they stated residents should be getting two showers per week.
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