Failure to Provide Scheduled ADL Care Including Nail Care and Showers
Penalty
Summary
The facility failed to provide adequate assistance with activities of daily living (ADLs), specifically nail care and showers, for two dependent residents. According to facility policy, residents are to receive assistance with bathing at least twice a week or as needed, with preferences reviewed quarterly. Documentation showed that one resident, who had severe cognitive impairment, received only four bed baths over a six-week period, with the last recorded on 6/2/25, despite scheduled shower days. Another dependent resident, who preferred showers, received only two showers in the same timeframe, with bed baths substituted despite the documented preference for showers. Observations revealed both residents had disheveled, greasy hair and long, dirty fingernails with debris under and around the nails. Staff interviews confirmed that nail care and bathing were not performed as scheduled, and there was a lack of clarity among CNAs and LPNs regarding nail care routines. No refusals for care were documented for either resident. The DON and facility administrator confirmed that nail care and showers should have been provided according to policy and resident schedules, but this was not done.