Failure to Provide Required Assistance with Personal Hygiene and Grooming
Penalty
Summary
A deficiency was identified when a resident with diagnoses including urinary tract infection and neuromuscular dysfunction of the bladder did not receive necessary assistance with activities of daily living, specifically in the areas of grooming and personal hygiene. The resident required substantial to maximal assistance with showering, bathing, and toileting hygiene, as documented in their care plan and physician orders. Despite these documented needs, the resident was observed multiple times over several days with greasy, unwashed hair and white flakes near the scalp, and reported not being cleaned up for the day or recalling their last shower. Review of treatment administration records revealed that prescribed genital care, including cleansing the foreskin twice daily with soap and water, was not completed on multiple occasions across several months. Observations and interviews confirmed that the resident's genital area had significant white buildup and the suprapubic catheter site had brown buildup, indicating a lack of proper hygiene. Certified nurse aides and nursing staff acknowledged that the resident's hair and genital area appeared unclean and that care was not consistently provided as required. Documentation showed that the resident did not refuse care, and facility policy required notification of supervisors if care was refused, which did not occur. Staff interviews confirmed that the expected standard of care, including regular washing of hair and genital area, was not met. The failure to provide these services was not in accordance with the resident's care plan, physician orders, or facility policy, resulting in the identified deficiency.