Failure to Provide Timely Personal Hygiene and ADL Assistance
Penalty
Summary
A resident with significant physical and cognitive impairments, including muscle wasting, multiple pelvic fractures, contractures, and memory problems, was observed in bed with a soiled gown and dry blood on her right nostril for an extended period. The resident was dependent on staff for all activities of daily living (ADLs), including bed mobility, eating, oral hygiene, and personal hygiene. During the observation, the resident appeared uncomfortable, contracted in both lower extremities, and expressed that she was waiting to be cleaned and was in pain. The assigned CNA reported a heavy workload, stating that she was responsible for multiple residents requiring showers and was unable to perform ADLs for the resident in a timely manner. The CNA noticed the dry blood but did not immediately notify the charge nurse, believing it was outside her scope and due to being busy. The LVN also observed the dry blood but did not clean it, assuming it would be addressed during the resident's scheduled shower. The DON confirmed that both CNAs and licensed staff are responsible for ensuring residents are clean and comfortable, and that delays in care can occur when residents require more time for ADLs. Facility policy requires staff to provide appropriate support and assistance with hygiene for residents unable to perform ADLs independently.