Failure to Provide Scheduled ADL Assistance and Personal Care
Penalty
Summary
The facility failed to provide adequate assistance with activities of daily living (ADLs) for four residents, specifically in the areas of bathing, showering, and nail care. Documentation revealed that one resident, who had physical and cognitive impairments and was scheduled for baths or showers three times a week, did not consistently receive the scheduled number of baths or showers over several months. Interviews with staff and the resident's power of attorney confirmed that the resident was not offered or given enough baths/showers as scheduled, and family members observed the resident to be visibly dirty and with a foul odor during visits. Staff also confirmed that all baths/showers and refusals should be documented, but shower sheets were missing for the relevant timeframes. Another resident reported not receiving hair or nail care unless provided by family, and documentation showed a lack of records regarding bathing, with only one refusal documented out of multiple opportunities. Staff interviews confirmed that residents should be offered showers multiple times per week, regardless of hospice status, but this was not consistently done. A third resident and their family reported missed scheduled baths, and documentation supported that only one shower was recorded for the month, despite a schedule of three per week. The DON confirmed that documentation showed insufficient offers or provision of baths and showers for these residents. A fourth resident requested nail care, stating that staff would not allow her to have a nail clipper and that her nails were getting too long. Staff interviews revealed that the request had not been communicated to the appropriate personnel, and the resident continued to wait for nail care. The DON stated that the expectation is for staff to provide nail care when requested and to communicate a timeframe if it cannot be done immediately. The lack of timely and documented ADL assistance, including bathing and nail care, was confirmed through interviews, record reviews, and direct resident and family reports.