Failure to Provide Adequate ADL and Personal Hygiene Care
Penalty
Summary
The facility failed to provide adequate assistance with activities of daily living (ADLs), specifically personal hygiene, to multiple residents who required such care. Observations and interviews revealed that several residents were left with unwashed, greasy hair, long and dirty fingernails, and unaddressed grooming needs. In several cases, residents and their family members reported that requests for assistance with hair washing, shaving, and nail care were not fulfilled by staff, with some residents stating that CNAs cited lack of time as a reason for not providing care. Family members of one resident reported having to perform nail care themselves due to staff inaction, expressing concern about the risk of infection from long, dirty nails. Documentation review showed that the affected residents had care plans indicating the need for assistance with ADLs, including grooming, nail care, and personal hygiene, due to various medical conditions such as impaired mobility, cognitive impairment, depression, and risk for skin integrity issues. Despite these documented needs, staff failed to provide regular and necessary care, as evidenced by residents' unkempt appearance and persistent hygiene issues over multiple days. Staff interviews confirmed that nail care and hygiene should be provided regularly, especially on shower or bath days, and that failure to do so could lead to skin breakdown and infection. Additionally, one resident was observed to have been transferred using a soiled mechanical lift sling and placed in a wheelchair with a foul odor, indicating a lack of attention to cleanliness and infection control. Staff acknowledged that slings and wheelchair cushions should be cleaned regularly and replaced when soiled. Facility policies reviewed by surveyors confirmed the expectation for daily ADL care and regular nail care to maintain cleanliness and prevent infection, but these standards were not met for the residents reviewed.