Failure to Provide Consistent ADL Care and Hygiene
Penalty
Summary
The facility failed to provide necessary care and assistance with activities of daily living (ADLs), including bathing, grooming, and hygiene, for multiple residents who were dependent on staff for these services. Several residents did not receive scheduled showers or bed baths as documented in their care plans, with records showing missed showers on specific dates and no documentation of resident refusals. Observations and interviews revealed residents with unwashed hair, body odor, dirty or untrimmed nails, and soiled clothing, indicating a lack of consistent personal hygiene care. Residents expressed dissatisfaction and distress regarding the lack of assistance with ADLs. Some reported that showers were not given regularly, and that staff would often tell them to wait for the next shift or only provide a quick wash with a wet cloth. Staff interviews confirmed that showers and other ADL tasks were sometimes missed due to staffing shortages or workload, and that not all residents' preferences or needs were being met as outlined in their care plans. In several cases, there was no documentation of refusals or alternative care provided when showers were missed. The affected residents had significant medical histories and cognitive impairments, making them reliant on staff for daily care. Observations included residents with dried food and wet spots on clothing, long and dirty fingernails, unshaven facial hair, and unchanged or soiled clothing. These findings were corroborated by both staff and resident interviews, as well as review of care plans and ADL task sheets, which consistently showed gaps in the provision of required personal care services.