Failure to Provide Scheduled ADL Care and Personal Hygiene
Penalty
Summary
The facility failed to provide adequate Activities of Daily Living (ADL) care, specifically personal hygiene and showers, for five dependent residents. Observations and interviews revealed that residents often did not receive scheduled showers or bed baths, resulting in poor hygiene, greasy hair, body odor, and unshaven appearances. Documentation showed that some residents received only one shower in a 14- or 30-day period, with no evidence of bed baths being provided as alternatives. In several cases, there was no documentation of resident refusals for showers or baths, and care plans lacked interventions for refusals or alternative hygiene measures. The deficiency was further compounded by facility infrastructure issues, as only one shower was available for 48 residents due to the removal of a tub in one shower room, which was being used for storage. This limited access to bathing facilities made it difficult to meet the scheduled shower frequency for all residents. Residents expressed dissatisfaction and emotional distress due to missed showers, with some reporting feelings of neglect and sadness. Medical records indicated that the affected residents had significant self-care deficits due to conditions such as Alzheimer's disease, recent amputation, stroke, muscle weakness, Parkinson's disease, and obesity. Despite these needs, care plans did not address the lack of hygiene care or provide strategies for managing refusals. Observations confirmed ongoing issues with personal hygiene, including greasy hair, unshaven faces, and skin irritation, with no evidence of appropriate interventions being implemented.