Deficiencies in Resident Hygiene and Grooming Care
Penalty
Summary
The facility failed to ensure that residents who were unable to carry out activities of daily living received the necessary services to maintain good grooming and personal hygiene. Specifically, Resident #25, who had diagnoses including unspecified dementia and stroke, was observed multiple times with visible food debris in both their upper and lower dentures. The care plan for Resident #25 did not document the presence of dentures or instructions for their care, and oral hygiene was marked as 'Not Applicable' in the Certified Nurse Aide task documentation. Interviews with staff revealed a lack of awareness and documentation regarding the resident's denture care needs. Resident #10, diagnosed with multiple sclerosis and diabetes mellitus type 2, was observed with long fingernails containing brown debris and 1/2 inch long white chin hairs. Despite the resident expressing a desire for assistance with nail care and chin hair removal, staff did not provide these services. Observations showed that during morning care, the resident's hands and nails were not cleaned, and chin hair was not removed. Interviews with Certified Nurse Aides indicated confusion about responsibilities for nail care and grooming, with some aides believing it was the responsibility of the Activities Department. The Director of Nursing and other staff interviews highlighted a lack of adherence to the facility's policies regarding personal hygiene and grooming. The care plans were not updated to reflect the residents' needs, and there was a failure to provide necessary hygiene services, impacting the residents' dignity and infection control. The facility's policies required regular monitoring and care for residents' oral hygiene and grooming, which were not followed, leading to the observed deficiencies.
Plan Of Correction
Plan of Correction: Approved January 8, 2025 1. Resident #25's care plan and closet care plan was updated by IDT. Resident received oral care on day of survey. The staff on resident #25 unit was educated on resident #25 care plan that reflects oral care CCP. Resident #10 has facial hair addressed during survey. Resident #10's care plan and closet care plan was updated by IDT. The staff on resident #10's unit was educated on facial care plan by RN Educator. A full house review of all residents was completed and all facial hair and nail care per preference was performed. Any deficient practices were corrected immediately. 2. All residents are at risk for deficient practices of ADL care not being completed per plan of care. 3. Policy and procedure titled ADL Care was reviewed by Director of Nursing and no changes were made to policy. 4. All nursing staff were educated by outside consultant on ADL care specifically dental care and facial hair. 5. All residents were audited for facial hair and dental care by RN and compared to CCP. Any deficient practices were corrected immediately. 6. Unit Managers/designee will conduct Care Plan, Closet Care Plan audits of 5 residents weekly on each unit for grooming needs/preferences. Unit LPNs will conduct 5 random observation audits of residents’ ADL/grooming/hygiene each shift during medication passes. Observation audits will be turned into the RN Supervisor/Unit Manager and then turned over to the DON for trending and analyzing. The Unit Managers will conduct 5 random interviews per week with residents regarding grooming and care preferences. Any deficient practices will be corrected and brought to QAPI for further review. Person Responsible: Director of Nursing