Failure to Provide Timely Assistance with ADLs and Grooming
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs), specifically in maintaining proper grooming and timely toileting hygiene, for five residents with varying degrees of physical and cognitive impairment. One resident, who was cognitively intact but required moderate assistance, reported waiting three hours after pressing the call bell at night before being changed out of wet clothing. Another resident, with moderate cognitive impairment and Parkinson's disease, was observed to have facial hair on the chin, which was confirmed by a licensed nurse. A resident with severe cognitive impairment and a contracture was observed to have long nails, despite a care plan specifying routine nail care, and the family expressed a desire for the nails to be kept short. Another resident, also severely cognitively impaired and with a recent arm fracture, was found with long nails and expressed a wish for them to be cut, which was confirmed by a nurse. Additionally, a resident with an above-knee amputation and muscle wasting, who required maximal assistance, reported being left in urine for approximately two hours during breakfast, with staff delaying care due to meal service duties. The resident also experienced a delay in care when a nursing aide was unsure of her assignment and turned off the call bell without providing assistance. Resident council feedback indicated that call bells were sometimes turned off by aides without providing care, particularly during shift changes and the evening shift. Family interviews corroborated delays in care, with one family member reporting that a resident was left in urine until after breakfast trays were collected. These findings were confirmed by staff interviews and observations, demonstrating a pattern of inadequate assistance with ADLs and grooming for multiple residents.