Failure to Provide Routine Personal Hygiene and Grooming for Dependent Residents
Penalty
Summary
The facility failed to provide routine personal hygiene and grooming, including nail care, hair care, and beard trimming, for two residents who were dependent on staff for activities of daily living (ADLs). One resident with moderate cognitive impairment and limited mobility was observed multiple times over several days with visibly soiled fingernails containing dark debris. Despite care plans and facility policies requiring assistance with personal hygiene and nail care, there was no documentation that nail cleaning was offered or performed, and staff interviews confirmed that nail care was only routinely done on bath days, with cleaning as needed if noticed. The resident was unable to recall when his nails were last cleaned or clipped, and staff acknowledged the importance of clean nails for hygiene and infection prevention. Another resident, who was cognitively intact but had significant physical limitations due to hemiplegia, muscle weakness, and other medical conditions, was observed with long, dull, and tangled hair, as well as an untrimmed mustache and beard. The resident reported that staff only used shampoo caps and did not assist with detangling hair or trimming facial hair, despite expressing a desire for these grooming tasks to be performed. Staff interviews revealed that haircuts and beard trims were not routinely offered or scheduled, and there was confusion among staff regarding responsibility for arranging these services. The resident expressed dissatisfaction with his appearance and the lack of assistance provided. Facility policies required that all residents receive assistance with morning cares, including ensuring nails are clean and trimmed to the resident's desired length, and that nail care be completed on bath day and as needed. The policies also specified that hair should be brushed daily and washed on shower days, with alternatives available for residents preferring sponge baths. Despite these policies, both residents did not receive the necessary personal hygiene and grooming assistance, as evidenced by direct observations, resident interviews, and lack of documentation in the medical record.