Failure to Provide ADL Assistance for Grooming and Hygiene
Penalty
Summary
Facility staff failed to provide necessary assistance with activities of daily living (ADLs) for two residents who were unable to perform these tasks independently, resulting in deficiencies in grooming and personal hygiene. One resident, admitted with diagnoses including encephalopathy, chronic respiratory failure, and muscle weakness, required extensive assistance for ADLs. Despite a care plan intervention to check, trim, and clean fingernails on bath days and as needed, the resident was observed with long, dirty fingernails and reported having requested nail care. An LPN acknowledged awareness of the issue but did not provide an explanation for not addressing the resident's nails. Another resident, dependent on staff for all ADL care and with severe cognitive impairment, had a physician's order for a podiatry consult for nail care. Observations over several weeks showed the resident's toenails remained long and unaddressed. Review of facility records revealed the resident's name was not entered in the podiatry consult book, and the facility's podiatrist confirmed never having seen the resident or being aware of a consult order. Interviews with staff indicated that the process for arranging podiatry consults was not followed, as the resident was not added to the required list or seen by the podiatrist. These findings demonstrate that the facility did not ensure residents who were unable to perform ADLs independently received the necessary services to maintain good grooming and personal hygiene, as required by facility policy and care plans. The deficiencies were identified through direct observation, record review, and staff interviews.