Failure to Provide Timely and Adequate Bathing Assistance per Resident Needs and Preferences
Penalty
Summary
Surveyors identified a failure to provide necessary assistance with personal hygiene in a timely manner and in accordance with resident preferences for two residents who required extensive help with activities of daily living. One resident, admitted after a fall at home with lower back fractures and assessed as cognitively intact and needing extensive ADL assistance, had a care plan stating they would receive a bed bath when a shower could not be tolerated, but the plan did not specify frequency or days. Bathing/Shower task forms showed this resident did not receive any showers over a several-week period and only received intermittent bed baths. In an interview, the resident reported not receiving showers or adequate bed baths since admission, describing the bed baths as limited to some wet wipes and not thorough, and stated they felt unclean and uncomfortable and had not received communication from staff about why showers were not being provided. Another resident, admitted after a recent left lower leg amputation and assessed as moderately cognitively impaired and needing extensive ADL assistance, had a care plan indicating they required one to two staff for transfers and that nails were to be cleaned and trimmed on bath day as necessary, but the plan did not specify how the resident was to be bathed or the number of bathing days per week. Bathing/Shower task forms showed this resident also did not receive showers over an extended period and only received two bed baths during that time. The unit manager LPN confirmed the task forms were accurate, that there was no additional documentation, and acknowledged noticing over the previous few weeks that residents were not receiving showers or baths, attributing this to floor aides being too busy. The administrator stated that residents should be receiving bathing services at least twice per week and that preferences should be reflected on the care plan. The deficiency was cited under WAC 388-97-1060(1)-(3).
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