Failure to Provide Required ADL Grooming Services for Dependent Residents
Penalty
Summary
Three residents who required moderate assistance with activities of daily living, including grooming and personal hygiene, were observed to have long and dirty fingernails on multiple occasions. Each resident had medical conditions such as polyneuropathy, cognitive communication deficits, congestive heart failure, shoulder pain, muscle weakness, Parkinson's disease, and diabetes, which limited their ability to perform personal hygiene tasks independently. Clinical record reviews and care plans confirmed their need for assistance with grooming and bathing. Despite these documented needs, staff did not provide the necessary services to maintain the residents' grooming, as evidenced by repeated observations of untrimmed and dirty fingernails. Interviews with the residents revealed that they preferred their nails short, wanted assistance, and had not been offered help with nail care prior to the survey. The DON confirmed that fingernails should have been trimmed during bathing and as needed, but this was not done for the residents in question.
Plan Of Correction
Resident 7 received assistance with her hair and fingernails. Resident 9 received assistance with nail care. Resident 116 received nail care. An initial audit will be completed by the DON or designee on current residents requiring assistance with ADLs to review they are being provided fingernails care. The nursing staff will be re-educated by the NPE/Designee to ensure that personal hygiene services will be provided to residents that require assistance with activities of daily living with focus on fingernails, hair grooming, and shaving. The DON/Designee will complete audits of 5 residents weekly x 8, monthly x 2 to ensure that personal hygiene services are being provided with the focus on fingernails care. Results of the audit will be reported to the Quality Assurance Performance Improvement Committee monthly.