Failure to Provide Scheduled Showers According to Residents’ Care Plans
Penalty
Summary
The deficiency involves the facility’s failure to provide bathing in accordance with residents’ plans of care and scheduled shower routines for three cognitively intact residents who required staff assistance with bathing. One resident with a BIMS score of 15 and assessed as needing substantial/maximal assistance with bathing was care planned to receive staff-assisted showers on Mondays and Thursdays and to be dependent on staff for transfers to the shower. Electronic health record (EHR) task documentation showed this resident received only one shower on 02/17/26 out of eight scheduled opportunities in February, with no documentation of showers on multiple other scheduled dates, and no additional shower documentation was produced upon request. The resident reported not receiving a bath the previous day and stated they had not had a bath in over a week. A CNA later confirmed they had been responsible for this resident’s bath on 03/02/26 but did not complete it due to lack of time during their shift. Two additional residents, both with BIMS scores of 14 and requiring partial/moderate or substantial/maximal assistance with bathing, were also not bathed according to their scheduled shower days. One resident, scheduled for showers on Tuesdays and Sundays, was documented as offered or receiving showers only three times during February, missing four other scheduled opportunities, and reported usually receiving only one shower per week. The other resident, scheduled for showers on Mondays and Fridays, was documented as receiving three showers out of eight scheduled opportunities in February and stated showers were not being given as often as they should be. Multiple CNAs reported that residents were supposed to receive two showers per week but that showers were often not completed due to short staffing and insufficient time during their shifts, with one CNA stating they were assigned six showers on a recent day but completed only two. An LPN stated the charge nurse was responsible for ensuring showers were given and that incomplete showers should be passed to night shift, and the DON acknowledged there had been staffing issues, while stating residents should be getting two showers a week.
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