Failure to Maintain Personal Hygiene for Residents
Penalty
Summary
The facility failed to provide necessary care and services to maintain personal hygiene for several residents, as observed and documented in the report. Resident #24, who was readmitted with diagnoses including dementia and anxiety, required substantial assistance with personal hygiene. Despite this, the resident was observed with greasy, matted hair, long fingernails with a brown and black substance underneath, and a pungent body odor. The resident repeatedly requested a diaper change, but the call light was on the floor, and the request was not promptly addressed by the staff. Resident #69, diagnosed with quadriplegia and anxiety, was dependent on staff for showers and personal hygiene. The resident's fingernails were observed to be long with a brown substance underneath, and the resident expressed an inability to cut them himself. Despite the resident's dependency, there was no documentation of care being provided or refusals being recorded, indicating a lack of adherence to the care plan. Resident #72, who was under hospice care with severely impaired cognitive skills, required total assistance for ADLs. The resident was observed with unkempt appearance, facial hair growth, and long fingernails with a brown substance. Scheduled showers were not documented as provided, and refusals were not consistently recorded. Similarly, Resident #83, also under hospice care, was observed with greasy, matted hair, long fingernails, and a need for water and a change of clothes. The resident's refusals of care were not documented, and the staff failed to provide necessary hygiene care. Resident #271 expressed a desire for a shower and shave, but there was no documentation of care being provided or refusals being recorded, highlighting a systemic issue in maintaining personal hygiene for residents.
Plan Of Correction
1: What corrective action(s) will be accomplished for those residents found to have been affected by the deficient practice; A. #24, grooming was completed, #69, nails were cut, #271, was shaved and showered, #72, was shaved and cut and clean, #83 was shaved, and were cut and cleaned. B. Rn staff J, CNA staff G, Unit Manager staff E, CNA staff C, CAN staff A, ADON, LPN staff W, Unit manager LPN staff M, CNA staff Q and CNA staff O were all educated on F677. 2: How you will identify other residents having potential to be affected by the same deficient practice and what corrective action will be taken; A. A complete audit was done on all residents for proper grooming and ADL care and any abnormal findings were corrected. 3: What measures will be put into place or what systematic changes you will make to ensure that the deficient practice does not recur; A. Licensed staff was educated on the components of F677. B. Nursing managers will review POC documentation the following business day for any refusal and completion of ADL care and follow up as needed. C. Nursing managers will review 24-hour report for any refusal or care and follow up as needed. D. Licensed staff was educated on documentation of care provided and refusal of care. E. Concierge rounds will include resident appearance, and any abnormal findings will be brought to morning stand up for further follow up. F. Education on F677 will be provided annually and upon new hire orientation. 4: How the corrective action(s) will be monitored to ensure the deficient practice will not recur, i.e., what quality assurance program will be put into place. The Director of Nursing/Designee will audit the resident appearance and random audits of the 24-hour report and POC for documentation weekly for four weeks then monthly for one quarter. The Director of Nursing/Designee will submit a report of findings to the Quality Assessment, Assurance and Compliance Committee monthly for one quarter. F 677