Health inspection·April 21, 2023

F 0561 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review, and resident and staff interview, it was determined that the facility failed to ensure that residents were being provided bathing as per their preferred schedules for two of six sampled residents. (Residents 2 and 4) Findings include: Clinical record review revealed that Resident 2 had diagnoses that included chronic respiratory failure and dementia. Review of the Minimum Data Set (MDS) assessment dated [DATE], revealed that the resident was totally dependent on staff for bathing and that choosing between a bath, shower or bed bath was a very important aspect of her routine. In an interview on April 21, 2023, at 10:00 a.m., Resident 2 stated that she was never sure when staff was going to offer her a shower. She further stated that she prefers to get a shower twice a week as per her schedule which is part of her routine. Review of the shower/bathing documentation for the last 30 days revealed that she preferred to receive assistance with showers on Tuesday and Friday evenings. On Tuesday April 4 and 11, 2023, and on Friday March 31 and April 7, 2023, staff noted that the task of assisting her with her shower as not applicable. There was no consistent documented evidence that staff were offering and providing assistance for the resident to receive her showers twice weekly as per her preferred schedule. Clinical record review revealed that Resident 4 had diagnoses of Alzheimer's and heart disease. The MDS assessment dated [DATE], revealed that the resident was totally dependent on staff for bathing and that choosing between a bath, shower or bed bath was a very important aspect of her routine. A review of the care plan revealed that the resident was at risk for a self care deficit related to decreased mobility and dementia. There was an intervention for the resident to receive baths twice weekly as per her schedule. In an interview on April 21, 2023, at 10:40 a.m., Resident 4 stated that the staff does not offer her a shower on a consistent basis twice weekly as per her preferred schedule. She further stated that she only recalls receiving assistance to get a shower one time in the recent weeks. The resident was already dressed and seated in her wheelchair at this time and she stated that staff did not offer to giver her a shower as scheduled today. Review of the shower/bathing documentation for the last 30 days revealed that she preferred to receive assistance with showers on Tuesday and Fridays. There was only one documented shower in the last 30 days. The other days were listed as either bed baths or not applicable. In an interview on April 21, 2023, at 11:25 a.m., the Assistant Director of Nursing, confirmed that there was no reason why residents were not getting their showers as preferred and scheduled. In a Page 1 of 2 395117 395117 04/21/2023 Lutheran Home at Topton, The One South Home Avenue Topton, PA 19562

F 0561 Level of Harm - Minimal harm or potential for actual harm second interview on April 21, 2023, at 12:16 p.m., the Administrator confirmed that there was no documented evidence that showers were being offered to residents on a consistent basis as per their preferred schedule. 28 Pa. Code 211.12(d)(1)(5) Nursing services. Residents Affected - Few 395117 Page 2 of 2