Failure to Provide Timely Personal Hygiene and ADL Care
Penalty
Summary
A deficiency occurred when a resident who was dependent on staff for activities of daily living (ADLs) did not receive necessary personal hygiene care, including nail care, in a timely manner. On observation, the resident was found in a wheelchair, wearing a hospital gown that left the front of the body exposed, without an incontinent brief, and was wet. The resident had long nails with blackish particles underneath, dirty hands, and was eating food with their hands without cutlery. Food was observed on the resident's lap, between their legs, and on the floor. The room had a foul urine odor, and the resident's hair was unkempt and matted. The resident, who was unable to move both lower extremities, had dry, peeling, and swollen skin on the legs. The resident stated that no staff had come to assist since the previous day. Staff interviews revealed that the assigned CNA had not provided morning ADL care or incontinent care to the resident and had not checked on the resident since the start of the shift. The CNA confirmed that the resident had not refused care that morning. The resident's care plan indicated a self-care deficit and required staff assistance with personal hygiene and maintaining skin integrity, including keeping fingernails short. Facility policy and CNA job descriptions required staff to provide ADL care, including bathing, grooming, and incontinence care, but these were not carried out as required for this resident.