Failure to Provide ADL Assistance with Grooming and Hygiene
Penalty
Summary
A resident with diagnoses of dementia and anxiety disorder, and a severely impaired cognitive status as indicated by a BIMS score of seven, was identified as requiring assistance with activities of daily living (ADLs) such as toileting, showering, dressing, and personal hygiene. The resident's care plan directed staff to provide bathing, showering, and grooming, including checking and cleaning nails on bath days and as needed. The resident's electronic medical record showed only one refusal of care in the past 30 days. Despite these documented needs and care directives, observations revealed that the resident had facial hair and dirty fingernails, indicating a lack of assistance with grooming and hygiene. Staff interviews confirmed that ADL assistance, including shaving, was expected during morning care or showers, and refusals were to be documented and reported. The facility was unable to provide a policy for activities of daily living when requested.