Failure to Provide Adequate ADL Assistance and Proper Hygiene Practices
Penalty
Summary
The facility failed to provide adequate assistance with activities of daily living (ADLs) for two residents who were dependent on staff support. One resident, with intact cognition and multiple diagnoses including cancer, heart failure, and malnutrition, required help with all ADLs. The resident's care plan did not include preferences or instructions for shaving and personal hygiene. Observations over several days showed the resident had significant facial hair, and interviews revealed that staff had not inquired about or assisted with shaving. The resident expressed a preference to be clean-shaven and stated that staff had not asked about or provided shaving assistance. The director of nursing confirmed that staff were expected to ask about shaving preferences and provide assistance, especially since the resident might not be able to request it due to confusion. Another resident, with moderate cognitive impairment and multiple chronic conditions, also required staff assistance with all ADLs. The care plan indicated a need for help with grooming but lacked specific directions for personal hygiene. During peri-care after incontinence, a nursing assistant used the same washcloth to clean both the buttocks and groin, which was acknowledged as an infection control concern by both the assistant and the infection preventionist. The facility's procedure required separate cleaning methods to prevent cross-contamination, but this was not followed. The activities of daily living policy was requested but not provided.