Failure to Provide Oral and Personal Hygiene for Dependent Residents
Penalty
Summary
The facility failed to provide necessary care and services to two residents who were dependent on staff for activities of daily living (ADLs), specifically in the areas of oral care and personal hygiene. One resident, with diagnoses including cerebral infarction, dementia, and aphasia, was observed with dry lips and a crusty yellowish film around the mouth. This resident was assessed as having severely impaired cognition and being fully dependent on staff for ADLs. During interviews, staff acknowledged the importance of oral care, especially for residents unable to perform self-care, and facility policy required oral care to be provided every shift and as needed. Another resident, with a history of cerebrovascular disease, hemiplegia, schizoaffective disorder, and major depressive disorder, was observed with long and dirty fingernails on both hands. This resident required partial to moderate assistance with personal hygiene and was care planned to receive ADL support and cues as needed. Observations showed the resident using dirty fingernails to eat, and staff interviews confirmed that fingernail care was not being consistently provided or communicated to the charge nurse as required by facility policy. Facility policies reviewed indicated that residents unable to perform ADLs should receive services to maintain good grooming, personal, and oral hygiene. However, direct observations and staff interviews demonstrated that these policies were not followed for the two residents, resulting in unmet hygiene needs.