Failure to Provide Showers and Grooming per Resident Preference
Penalty
Summary
The facility failed to provide care and assistance with activities of daily living (ADLs), specifically in administering showers and shaving, according to resident preferences for two residents. One resident, who was cognitively intact but required assistance due to hemiplegia and poor vision, reported not being regularly shaved or given scheduled showers. Documentation showed that out of 22 scheduled showers, only 10 were administered, with no record of the resident refusing care. Staff interviews revealed uncertainty about shaving frequency and reliance on shower days for shaving, while the Assistant Director of Nursing was unsure about the shaving schedule. Observations confirmed the resident had extensive facial hair and reported not being shaved as preferred. Another resident, dependent for all personal care due to Parkinson's disease and cognitive impairment, was observed multiple times with unshaven facial hair and brown debris under fingernails. Documentation indicated only 6 out of 22 scheduled showers were administered, again with no record of refusals. The facility's policies addressed AM care and fingernail cleaning but did not provide a specific policy for administering showers or bathing. The Director of Nursing confirmed the use of internal shower sheets, which were not retained as part of the medical record.