Failure to Provide Necessary ADL Assistance and Personal Hygiene
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs), specifically in maintaining good grooming and personal hygiene, for several residents who were dependent on staff for these tasks. Multiple residents with severe cognitive impairment, physical disabilities, or blindness were observed to have long, dirty, and untrimmed fingernails. In several cases, residents expressed that they could not trim their own nails and wanted staff assistance, but their needs were not met. Staff interviews revealed confusion about responsibilities for nail care, particularly for diabetic residents, and a lack of awareness regarding the condition of residents' nails. Additionally, the facility did not consistently provide scheduled showers or baths for a resident who was totally dependent on staff for bathing and personal hygiene. Documentation showed that this resident missed multiple scheduled showers, with no records of refusals or alternative care being provided. Staff interviews indicated that showers and refusals were supposed to be documented and reported to the charge nurse, but this process was not consistently followed. The resident confirmed that she had not received showers for an extended period and wanted to be showered. Record reviews and staff interviews further highlighted that the facility's policies required daily observation and as-needed care for personal hygiene, including nail care and bathing. However, there was a lack of adherence to these policies, as evidenced by the missed care and inconsistent documentation. The failures in providing necessary ADL care were observed directly by surveyors and confirmed through interviews with residents and staff.