Failure to Provide Adequate Bathing and Nail Care for Dependent Residents
Penalty
Summary
The facility failed to provide necessary services to maintain good grooming and personal hygiene for residents who were unable to perform activities of daily living independently. Multiple residents with significant medical conditions and cognitive impairments were observed to have unmet hygiene needs, including inadequate bathing and nail care. For example, one resident with cerebrovascular disease and major depression, who was cognitively intact and required assistance with personal hygiene, was found to have long, dirty fingernails despite having requested staff assistance to trim them. A licensed practical nurse confirmed the need for nail care after direct observation. Another resident with severe obesity, diabetes, and multiple mobility issues, who required maximal assistance for bathing and hygiene, reported not receiving scheduled bed baths. Documentation confirmed that this resident received significantly fewer baths than scheduled, with no record of refusals or alternative care provided. The director of nursing verified the lack of documentation for missed baths. Similarly, a resident with dementia and muscle weakness, requiring substantial assistance, was observed on multiple occasions to have very long fingernails, which was acknowledged by the director of nursing during an in-room observation. Additionally, a resident with cerebral infarction, diabetes, and psychiatric diagnoses, who was cognitively intact and required substantial assistance with personal hygiene, was observed to have lengthy facial hair on multiple occasions. Bathing documentation for this resident was also incomplete, with only a few baths recorded over a two-month period despite a regular schedule. Staff interviews confirmed the expected bathing schedule, and the director of nursing acknowledged the lack of documentation for completed baths.