Failure to Provide Routine Personal Hygiene for Dependent Residents
Penalty
Summary
The facility failed to ensure that routine personal hygiene, including showers, hair care, and shaving, was completed for two residents who were dependent on staff for activities of daily living (ADLs). One resident, who was cognitively intact but had significant physical impairments and was dependent on staff for all personal hygiene, was observed with a two-inch long beard despite expressing a preference to be clean-shaven. Documentation and care plans lacked specific instructions or preferences regarding shaving, and staff interviews confirmed that the resident had been requesting to be shaved for several weeks without the request being fulfilled due to staff being too busy. Another resident, also cognitively intact but with multiple medical diagnoses and a self-care deficit, required staff assistance for bathing, dressing, grooming, and oral hygiene. The care plan did not include the resident's preferences or evidence of refusals for bathing or assistance. Weekly skin assessments and progress notes showed repeated refusals of baths, but there was no documentation of staff offering additional opportunities for bathing or partial baths, nor was there evidence of staff reapproaching the resident or documenting interventions. Observations revealed the resident appeared disheveled with a large, matted clump of hair, and staff interviews confirmed the lack of recent bathing and grooming. The facility's policy required that care and services be provided based on comprehensive assessment and resident needs and choices, to ensure that abilities in ADLs do not diminish unless unavoidable. However, the lack of documentation, failure to follow up on resident requests and preferences, and insufficient attempts to provide or document personal hygiene care led to the deficiency identified during the survey.