Failure to Provide Personal Hygiene and Nail Care Assistance
Penalty
Summary
The facility failed to provide necessary personal care and assistance with activities of daily living for two residents who were unable to perform these tasks independently. One resident, admitted with multiple diagnoses including a recent amputation, diabetes, and vascular disease, was documented as requiring moderate assistance with personal hygiene. Despite being cognitively intact and expressing a clear preference to remain clean-shaven, the resident reported only receiving a shave once in the facility's barber shop, for which they had to pay. Over several days of observation, the resident continued to have a significant growth of facial hair, and staff interviews confirmed that CNAs were responsible for assisting with shaving but had not consistently provided this care as requested by the resident. Another resident, admitted with a history of stroke, paralysis, and chronic illnesses, was identified as having a self-care deficit and required assistance with nail care. Although records indicated that the resident's nails were checked regularly, direct observation revealed that the resident's toenails were long, curled, discolored, and jagged. The resident confirmed that the condition of their toenails was bothersome and had been reported to nursing staff multiple times. Interviews with CNAs and nursing staff revealed that there was an established process for nail care, particularly for residents with diabetes or other complicating conditions, but the process was not followed in this case. The resident was not listed for podiatry care, despite the need for professional attention to their toenails. Facility policies required that residents unable to perform activities of daily living independently receive necessary services to maintain grooming and hygiene, and that foot care be provided in accordance with professional standards. Staff interviews confirmed awareness of these policies and the procedures for providing or escalating care needs. However, the failure to provide timely and appropriate assistance with shaving and toenail care for these two residents resulted in unmet personal care needs, as directly observed and reported during the survey.