Deficiency in Personal 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, two residents were affected by this deficiency. Resident #39, who had diagnoses including osteomyelitis, gastrostomy, and atrial fibrillation, was observed to have a long, unkempt beard and was not gotten out of bed on multiple days. Despite expressing a desire to be shaved and to get out of bed, staff did not offer these services, citing reasons such as the resident's pressure sore and lack of a chair. The resident's care plan indicated a need for assistance with transfers and personal hygiene, but these needs were not met. Resident #96, who had diagnoses including a fracture of the orbital floor, major depressive disorder, and osteoarthritis, was observed with long, jagged, and dirty fingernails, as well as long whiskers on their face and chin. The resident, who was legally blind, expressed discomfort with their whiskers and difficulty manipulating food due to their nails. Despite this, staff did not offer to shave the resident or provide nail care during morning care. The resident's care plan required assistance with personal hygiene, but these services were not adequately provided. Interviews with staff revealed a lack of communication and responsibility regarding the provision of personal hygiene care. Certified Nurse Aides and Licensed Practical Nurses acknowledged the importance of offering shaving and nail care for dignity and infection control reasons, yet these services were not consistently offered or provided. The Director of Nursing and other supervisory staff indicated that these deficiencies were not in line with the facility's policies and expectations for resident care.
Plan Of Correction
Plan of Correction: Approved March 11, 2025 All staff involved with caring for resident #39 and #96 were counselled regarding ADL Care. Resident #96’s facial hair was trimmed and his fingernails were cleaned, trimmed, and filed. Resident #39’s facial hair was shaved. A wheelchair with offloading cushion was also provided for resident for opportunity to be out of bed. Care plans for residents #39 and #96 were reviewed and revised regarding ADL care and OOB schedule as indicated. All Residents in the facility will be reviewed and ADL rounds performed to ensure nail care and shaving were offered and performed where warranted. The facility will conduct a review on all other residents to ensure they are gotten out of bed per Care Plan. The ADL Policy was reviewed by the Regional Nurse with no revisions required. All CNA’s and Licensed Nursing Staff will be educated by the RN Educator/Designees on policy/procedure for ADL care, including nails and facial hair/grooming. Education will also include the need to get residents out of bed per the Care Plan. DON/Designee will perform ADL audits on five residents per unit weekly x 4 weeks then bi-weekly x 2 months. These audits will include that Facial Hair is trimmed, nails are cleaned and residents are gotten out of bed per policy and Care Plan. Audit findings will be reported to the QAPI committee for review. Responsible Person: DON