Failure to Provide Necessary ADL Assistance for Dependent Residents
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs) for three residents who were dependent on staff for personal hygiene. For one resident with diabetes, observations showed long fingernails with brown material underneath, and the resident reported repeatedly requesting nail trimming, which was not provided despite a care plan and physician order specifying weekly diabetic nail care by a licensed nurse. Staff interviews confirmed that both CNAs and nurses were aware of the need for nail care, but the resident's nails remained untrimmed and unclean over several days. Another resident, also requiring substantial assistance for personal hygiene, was observed multiple times with dark brown matter under their fingernails. Staff acknowledged that cleaning and trimming nails was part of personal hygiene responsibilities, and interviews confirmed that the resident needed help with nail care, which was not being provided as expected. The Director of Nursing stated that dependent residents' nails should be clean and trimmed, especially for those unable to perform self-care. A third resident, who required moderate assistance with personal hygiene and had visual impairment, was observed on several occasions with yellowish crusty matter on their eyelids. The resident reported difficulty opening their eyes and stated that staff did not assist with cleaning their eyes, despite being unable to do so independently. Staff interviews confirmed that aides were responsible for daily eye care, but this was not being performed, leaving the resident with ongoing hygiene issues.