Failure to Maintain Personal Hygiene for Dependent Residents
Penalty
Summary
The facility failed to maintain adequate personal hygiene and grooming for residents who are dependent on staff assistance for activities of daily living. Resident R114, who is totally dependent on staff for assistance, was observed with long and dirty fingernails despite his preference for short nails. His comprehensive care plan specifically included an intervention to keep his fingernails short due to his potential for skin integrity impairment related to decreased mobility and incontinence. Observations over several days confirmed that his nails remained untrimmed, and the unit manager acknowledged that it was the responsibility of the nursing assistant to ensure they were cut. Similarly, Resident R60, who requires setup or clean-up assistance with personal hygiene, was found with very long and dirty fingernails. Although he is independent in some activities, he cannot cut his nails himself and had been waiting for a nurse to assist him. Despite having intact cognition, he expressed that he had not received the necessary assistance until a specific nurse eventually cut his nails. Interviews with staff revealed that Resident R60 sometimes refuses care and prefers certain caregivers, which may have contributed to the delay in receiving the necessary grooming assistance.
Plan Of Correction
Step 1 Resident R114, E22, R60, E23, E24 nails were trimmed and cleaned. Step 2 All residents audited, nails cleaned and trimmed to ensure adequate personal hygiene and grooming for all residents who are dependent on staff for ADL. Step 3 Nursing staff educated on adequate personal hygiene and grooming for residents who are dependent on staff for assistance with ADL. Step 4 Managers/ designee will conduct audits weekly x4, monthly x 2 as per facility protocol. Findings will be reviewed during QAPI meeting.