Failure to Provide Necessary ADL Assistance for Personal Hygiene
Penalty
Summary
A deficiency was identified when a resident with severe cognitive impairment and multiple medical conditions, including unspecified psychosis, end stage renal disease, right hand contracture, type 2 diabetes mellitus, and dependence on renal dialysis, did not receive necessary assistance with activities of daily living (ADL) to maintain good personal hygiene. The resident was documented as requiring substantial to maximal assistance with bathing and grooming, as indicated in the quarterly Minimum Data Set (MDS) assessment. Despite this, repeated observations over several days showed that the resident's facial hair was poorly groomed and unshaven while seated in a wheelchair at the nurses station and while lying in bed. Interviews with facility staff, including an LPN and a CNA, confirmed that the resident was supposed to receive a bed bath daily, which included shaving, and that the resident should have been shaved during the night shift bath. However, the observations indicated that this aspect of care was not consistently provided, resulting in the resident not being neatly groomed or shaved as required.