Failure to Provide Adequate Assistance with Personal Hygiene and Dining
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs), including personal hygiene and dining, for six residents who were dependent on staff support. Observations and record reviews revealed that multiple residents had untrimmed, dirty fingernails and toenails, and some had not received regular oral care. For example, one resident with paraplegia had long, thick, yellow toenails and stated that it had been a while since they were last trimmed. Another resident, dependent on staff for personal hygiene, had toenails approximately one-fourth inch in length and reported that staff only occasionally clipped them. Additional residents were observed with dirty fingernails, debris under their nails, and incomplete or irregular nail care, despite care plans indicating the need for staff assistance. Residents also experienced lapses in oral hygiene and assistance with meals. One resident with hemiplegia and hemiparesis was observed multiple times unable to reach or open items on their meal tray due to physical limitations, with staff failing to provide necessary setup or positioning assistance. This resident also reported inconsistent help with oral care, and was observed with visible debris on their face and mouth. Another resident was found with yellow-brown substance on their teeth and white crust at the corners of their mouth, and staff were observed using an unlabeled or incorrect toothbrush and basin, failing to ensure proper identification and hygiene supplies. Interviews with staff confirmed that CNAs were responsible for providing personal care, including nail and oral hygiene, but observations indicated that these tasks were not consistently performed as required by facility policy and individual care plans. The deficiencies were identified through direct observation, record review, and staff and resident interviews, demonstrating a pattern of inadequate assistance with ADLs for residents dependent on staff support.