Failure to Provide Adequate ADL Care and Personal Hygiene
Penalty
Summary
The facility failed to provide adequate activities of daily living (ADL) care, including personal hygiene and grooming, for five residents who were dependent on staff assistance. Multiple observations and interviews revealed that residents had long, jagged, or dirty fingernails, unshaven facial hair, and had not received regular showers or baths. In several cases, residents expressed a desire for nail care, shaving, or bathing, and staff confirmed the need for these services. Documentation did not consistently reflect refusals of care, and in some cases, there was no record of refusals despite staff claims that residents declined care. Residents affected included individuals with varying degrees of cognitive impairment and medical conditions such as diabetes, hemiplegia, chronic obstructive pulmonary disease, dementia, and end stage renal disease. For example, one resident with hemiplegia and diabetes had long, jagged fingernails and stated he did not like them that way, while another resident with moderate cognitive impairment had significant facial hair and could not recall the last time he received a shower. Another resident with severe cognitive impairment was observed with facial hair and had only refused care once in the past month, despite staff statements that she often refused grooming. Staff interviews confirmed the observations and acknowledged the importance of maintaining residents' hygiene and grooming to prevent health decline and preserve dignity. The facility's policy required monthly assessment and documentation of nail care and personal hygiene, including attempts to address refusals in residents with cognitive impairment. However, the lack of consistent documentation and failure to provide necessary ADL care led to the deficiency, as residents were not maintained in a clean, well-groomed condition as required.