Failure to Provide Bathing and Personal Hygiene Assistance
Penalty
Summary
The facility failed to provide adequate bathing and personal hygiene assistance to a resident with bilateral above-the-knee amputations who required substantial to maximal assistance with activities of daily living (ADLs). Despite being cognitively intact and not exhibiting care-resistant behaviors, the resident was repeatedly observed over several days with matted, uncombed hair, an unshaven face, and long, discolored fingernails with brown matter underneath. The resident reported not having received a bath or shower since admission, being left in wet briefs for extended periods, and not having his fingernails properly cleaned or trimmed according to his preferences. Staff interviews revealed inconsistent documentation and communication regarding the resident's care refusals and preferences. The LPN stated that refusals for bed baths were not documented, and the care plan did not reflect the need for segmented care or the resident's specific nail care needs. The CNA confirmed that nail care was only fully addressed after several days and that refusals were verbally reported but not documented. The DON was unaware that the care plan and MDS did not reflect the resident's refusals and could not provide documentation of such refusals. Additionally, the facility lacked a policy for ADL care or shower/bath procedures.