Failure to Provide Adequate Bathing and Grooming for Dependent Residents
Penalty
Summary
The facility failed to provide adequate bathing opportunities and grooming, specifically shaving, in accordance with the preferences and needs of two dependent residents. One resident with Alzheimer's disease and major depressive disorder was dependent on staff for all activities of daily living, including bathing and grooming. Documentation showed that this resident received only one shower over a four-week period, with only four bathing opportunities offered, despite the minimum requirement of eight unless otherwise indicated by resident preference. The care plan did not include the resident's bathing preferences or schedule, and there was a lack of documentation regarding bathing opportunities offered or refusals. Observations confirmed the resident had prominent beard stubble, and staff interviews revealed that shaving was typically provided during baths or as needed, but documentation and follow-up on refusals were inconsistent. Another resident with diabetes mellitus and end-stage renal disease also required moderate to maximal assistance with personal hygiene, including shaving, due to involuntary movements and cognitive impairment. The care plan indicated the resident preferred to maintain a mustache and would request shaving or trimming as needed. However, records showed only six bathing opportunities were offered over a similar period, with several refusals and instances where bathing was marked as non-applicable. Observations found the resident with prominent beard stubble and a mustache, and the resident expressed a desire for assistance with shaving. Staff interviews confirmed the resident's increasing need for help with personal hygiene due to worsening tremors, but documentation of offered and refused services was incomplete. Facility policy required that residents dependent on staff for activities of daily living receive necessary services to maintain grooming and personal hygiene, based on comprehensive assessment and resident choice. Despite this, both residents did not receive the minimum required bathing and grooming opportunities, and staff failed to consistently document offers and refusals or follow up as required. These deficiencies were confirmed through record review, staff interviews, and direct observation.