Two residents dependent on staff for ADLs did not receive showers as scheduled or per preference. One resident with diabetes, HF, depression, and HTN reported going weeks without a shower and said staff only gave bed baths; another resident with legal blindness, schizoaffective disorder, HTN, and chronic pain syndrome reported not getting the twice-weekly showers ordered in his care plan. CNA interviews cited staffing shortages and inability to complete all assigned showers, and the DON confirmed bathing was documented in the EHR.
A resident with dementia and other diagnoses was dependent on staff for bathing and was scheduled for showers twice weekly, but the bathing record showed a 10-day period with no documentation that a bath or shower was offered, received, or refused. The DON confirmed the gap and could not explain why it occurred. Facility policy required documentation of completed bathing, refusals, and interventions.
Failure to provide timely ADL assistance affected three residents who were dependent on staff for meals, toileting, and bathing. One resident who required a mechanical lift and help with eating was not always gotten up for lunch, another resident reported waiting too long for bedpan assistance and having bowel/bladder accidents with red, irritated peri-area skin, and a short-stay resident had no documented baths or showers despite a scheduled shower plan. The Administrator confirmed there was no evidence the resident received bathing before the family complaint.
A resident who was dependent for bathing and other ADLs was scheduled for showers twice weekly, but facility documentation showed multiple missed showers over several weeks. The resident reported not receiving showers as scheduled, and the DON confirmed the shower schedule and the missed documentation on the STNA skin condition report sheet.
A facility failed to ensure dependent residents received timely bathing and personal hygiene assistance. One resident missed multiple showers and reported going over a week without one, another had no documentation of any bath or shower during the stay, and a third resident was observed with facial hair that had not been shaved despite needing substantial to maximum help with personal hygiene.
Failure to provide bathing and grooming assistance: A resident with multiple chronic conditions and extensive ADL needs was care planned for twice-weekly showers with two-staff assistance, but was observed in soiled clothing and not well groomed. He stated he had not received any shower since admission and preferred staff help with shaving. Documentation showed no showers or bed baths were provided during the first several days of the stay, and the RN/UM confirmed this.
A resident with MS, Alzheimer's disease, and major depressive disorder had moderate cognitive impairment and needed partial/moderate help with personal hygiene. Surveyors observed numerous and long facial hair on the resident's upper lip and chin on multiple occasions, and the resident stated she wanted her facial hair shaved. An UM later verified the resident had a shower the prior day but still had noticeable facial hair.
A resident with multiple diagnoses, including CVA, CHF, anemia, asthma, hypothyroidism, and pulmonary HTN, was cognitively intact but required assistance with bathing and other ADLs. Facility shower records showed only three showers and one refusal, with no documentation of a shower or bed bath on numerous days despite the resident being care planned for two showers weekly. The DON stated CNAs were to offer showers and provide a bed bath if refused, and the Administrator confirmed no additional bathing documentation was found.
A resident with traumatic subdural hemorrhage, depression, anxiety, and moderately impaired cognition required substantial assist for transfers but did not receive timely help getting out of bed. Staff answered and turned off the call light, but the resident remained in bed for an extended period before a CNA and PTA completed the transfer; an LPN stated she had just been asked to assist, and the facility policy required timely response to call lights.
A resident who was dependent on staff for toileting hygiene and always incontinent of stool was left in a soiled brief with dried stool on the skin and a strong stool odor in the room. Staff reported the resident had last been changed hours earlier, and CNAs stated the unit was short-staffed, residents had to wait during meals or tray pass, and one CNA delayed care until after break. The resident was also observed with redness of the buttocks and food on the chest while lying in bed.
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