Failure to Provide ADL Care: Deficiencies in Nail Care and Shaving
Penalty
Summary
Surveyors identified that the facility failed to provide adequate Activities of Daily Living (ADL) care for three residents, specifically related to personal hygiene tasks such as nail care and shaving. One resident was observed with long, jagged nails and reported not remembering the last time they were trimmed, despite expressing a desire for nail care. Both a CNA and a registered nurse confirmed the need for nail trimming, with the nurse acknowledging responsibility but stating the task had not been completed. Another resident, who required substantial assistance with personal hygiene due to severe cognitive impairment, was observed with unshaven facial hair and stated a preference to be shaved while keeping his mustache. Staff interviews confirmed that shaving should occur during bath times, but the resident remained unshaven, resulting in an untidy appearance. A third resident, diagnosed with Parkinson’s Disease and cognitively intact, was observed with significant facial hair and stated he could not shave himself but would like to be shaved. Staff interviews revealed that shaving was typically performed on shower days, but documentation showed no record of recent shaving or refusals. The MDS Coordinator confirmed that the resident had not been shaved in some time, and the CNA who usually performed this task was on leave. The facility lacked a personal hygiene policy but had a nail care policy requiring proper nail maintenance. These findings were based on direct observations, resident and staff interviews, and record reviews.