Failure to Provide Adequate Bathing and Nail Care for Two Residents
Penalty
Summary
The facility failed to provide adequate care and assistance with activities of daily living for two residents, resulting in deficiencies related to personal hygiene and grooming. One resident, who had chronic obstructive pulmonary disease, generalized muscle weakness, neuromuscular bladder dysfunction, and an indwelling urinary catheter, was dependent on staff for bathing and other ADLs. Despite care plans and staff expectations for regular showers or bed baths, the resident reported only receiving two showers and described bed baths as inadequate, with CNAs using only lightly wetted washcloths and not following proper procedures. Documentation in the electronic health record confirmed only one shower was recorded, and staff interviews acknowledged the lack of proper bathing and documentation, which was essential for cleanliness and infection prevention, especially given the resident's catheter use. Another resident, with diagnoses including schizophrenia and muscle weakness, required moderate assistance with ADLs and had intact cognition. Observations revealed this resident had visibly long, irregular fingernails with dark brown debris underneath, which curled over the fingertips. The resident stated that nail care had not been provided for some time. Staff confirmed that nail care, including cleaning and trimming, was their responsibility and should be performed daily to maintain hygiene and prevent potential health issues. The DON also stated that dirty fingernails were unacceptable and increased the risk of infection, particularly when residents handled food or shared items. Facility policies reviewed indicated that showers and nail care were to be provided routinely to ensure cleanliness, comfort, and prevention of body odors and infection. However, the observed and documented failures to provide these services as required led to deficiencies in maintaining good grooming and personal hygiene for the two residents involved.