Failure to Provide ADL Assistance and Hygiene Care
Penalty
Summary
A deficiency occurred when a resident who was dependent on staff for activities of daily living (ADLs) was not provided with adequate hygiene care. Observations revealed that the resident's fingernails were long, sharp, and had a brown substance caked underneath. The resident had not received a documented bath or shower for the entire month of July, despite being scheduled for bathing twice weekly. Staff interviews confirmed that nail care and hand hygiene were not consistently performed, and there was no documentation of these tasks in the electronic health record (EHR). The resident expressed a desire to be cleaned and have his nails cut, and staff acknowledged the importance of maintaining hygiene to prevent infection and injury. The care plan for the resident indicated a self-care deficit related to cognitive impairment and poor judgment, with goals to maintain personal hygiene with staff assistance. The care plan also emphasized the importance of keeping the skin clean and dry to prevent skin tears and infection. Facility policy required that residents unable to perform ADLs independently receive necessary services to maintain good grooming and hygiene. However, the lack of documented bathing, nail care, and hand hygiene for this resident demonstrated a failure to follow the care plan and facility policy, resulting in the resident not receiving essential hygiene care.