Failure to Provide Required Assistance With Bathing and Toileting
Penalty
Summary
The deficiency involves the facility’s failure to provide required assistance with activities of daily living (ADLs), specifically bathing and toileting, to dependent residents. One resident admitted with muscle weakness and adult failure to thrive had an admission MDS indicating moderate cognitive impairment and dependence on staff for showers. CNA task documentation for a specified 10‑day period showed the resident did not receive any type of bathing, with entries marked as “NA” on two of those days. A CNA later stated she documented “NA” when she did not have time to provide a shower during that period, and another CNA stated that during that time showers were not always offered to residents. The DNS stated she would expect residents to receive their scheduled showers. Another resident, admitted with chronic kidney disease and UTI, was cognitively intact, dependent on staff for toileting transfer and hygiene, and occasionally incontinent of bladder. This resident reported having to wait up to an hour at times for staff assistance with toileting, particularly during the daytime, and described experiencing pain and an urgent need to urinate during these waits. A former CNA and another CNA both stated they had observed this resident have incontinent episodes after waiting too long for toileting assistance, and one CNA reported seeing the resident’s call light on and being told the resident was waiting to use the toilet, after which she would apologize when she could not meet care needs promptly. A third resident, admitted with muscle weakness and a need for assistance with personal care, had an MDS and care plan indicating a need for partial to maximal assistance with bathing and was scheduled for bathing twice weekly in the evening. Documentation showed this resident received bathing only four times in a given month and went a 10‑day span without any bathing. A complaint was later received by the State Survey agency alleging this resident was not receiving bathing, and an agency CNA stated she did not recall refusals of bathing and at times could not complete the resident’s bathing. The DNS stated she would expect residents to receive their scheduled showers.
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