Failure to Provide Scheduled ADL Care and Personal Hygiene Services
Penalty
Summary
Facility staff failed to provide necessary care and services to maintain good personal hygiene and prevent body odor for four residents who were unable to perform their own activities of daily living (ADLs). Multiple instances were documented where residents did not receive scheduled showers, bed baths, nail care, shaving, or haircuts as outlined in their individualized care plans. Documentation was often missing regarding whether care was offered, refused, or provided, and there was a lack of follow-up when residents reportedly refused care. In several cases, there was no resident signature to confirm refusals, and staff did not consistently attempt to reschedule or offer care at a later time. Residents affected by these deficiencies included individuals who were cognitively intact, dependent on staff for bathing and personal hygiene, and in some cases, frequently or always incontinent of urine and/or bowel. Observations revealed that residents had greasy, matted hair, facial hair, long and dirty fingernails, dry and flaky skin, and rooms with noticeable body odor. Interviews with residents confirmed that they had not received showers, shaves, or haircuts for extended periods, despite expressing a desire for such care. Some residents reported that staff told them services like haircuts could not be provided due to regulations, and others stated that staff promised to provide care but did not follow through. Staff interviews revealed inconsistencies in understanding and executing responsibilities for ADL care. CNAs and nurses gave conflicting accounts regarding who was responsible for nail care, shaving, and grooming, particularly for diabetic residents. The facility lacked specific policies for showers, shaving, nail care, or haircuts, and staff assignments for showers and grooming were not always completed as scheduled. Family members and responsible parties also reported concerns about the lack of ADL care, with some having to provide grooming themselves or escalate complaints to facility leadership.