Failure to Provide Consistent ADL Care for Dependent Residents
Penalty
Summary
The facility failed to provide adequate activities of daily living (ADL) care for two residents, as evidenced by clinical record reviews and staff interviews. Resident 65, who was dependent on staff for bathing, had a significant change MDS assessment indicating the importance of choosing between different types of baths. However, task documentation showed inconsistent bathing schedules and instances where the resident refused or was not documented as having received a bath. There was no evidence that staff re-approached or offered bathing opportunities on subsequent shifts or days. Additionally, there were multiple instances where hair cleansing was either not documented or refused, with no follow-up actions taken by the staff. Observations of Resident 65 revealed disheveled hair, indicating a lack of proper grooming. Resident 89, admitted with dementia and adult failure to thrive, required assistance with bathing and personal hygiene. Task documentation indicated that showers were scheduled twice a week, but records showed infrequent bathing and numerous refusals without documentation of re-approach or alternative bathing opportunities. The care plan for Resident 89 lacked interventions for addressing bathing refusals. These deficiencies were discussed with the Director of Nursing during the survey, highlighting the facility's failure to ensure consistent and adequate ADL care for dependent residents.
Plan Of Correction
Cited: Resident 65 and resident 89 bathing preferences were collected and honored. • Like: Facility wide sweep will be completed to ensure residents bathing preferences are honored. • Education: NHA/designee will educate staff on resident bathing preferences. • Audits: NHA/designee will audit 5 residents weekly x 4 weeks and monthly x2 months to ensure resident bathing preferences are being honored. Results will be taken through QAPI.