Failure to Provide Scheduled Showers and Nail Care for Dependent Residents
Penalty
Summary
The facility failed to provide routine nail care and scheduled showers for three residents who required staff assistance with activities of daily living (ADLs). For one resident with multiple diagnoses including dysphagia, aphasia, heart failure, and obesity, the care plan required staff assistance for ADLs and scheduled showers twice weekly. Documentation revealed that this resident missed several scheduled showers over a three-month period, with confirmation from the Regional MDS Coordinator that showers were not provided as scheduled. Another resident, with severe cognitive impairment and multiple complex medical conditions such as metabolic encephalopathy, sepsis, and Alzheimer's disease, required extensive staff assistance for self-care and mobility. The care plan specified nail care on shower days and as needed. Observations on two consecutive days found the resident's nails to be long and dirty with a brown substance underneath, and both an LPN and an RN confirmed the need for nail care at the time of observation. A third resident, who was cognitively intact but dependent on staff for functional abilities including bathing, received only one bath during a one-month period despite being scheduled for showers twice weekly. Review of documentation and interviews with the DON confirmed that there was no additional bath or refusal documentation for this resident. Facility policy required bathing at least twice a week unless otherwise specified by resident preference, but this was not adhered to for the residents involved.